Case studies

Describes the integrated age- and dementia friendly efforts of some Massachusetts communities.  

Table of Contents

Cape Ann

In 2017, the Age & Dementia Friendly Cape Ann Initiative (ADFCA) became among the first to integrate the age- and dementia friendly movements at the outset. Moving away from the separation of the two movements, ADFCA felt this integration was important to include the voice of people living with dementia and/or their care partners in every area of focus. ADFCA strives to make sure that voice is included in each of their action teams. ADFCA encompasses the four communities of Cape Ann: Gloucester, Rockport, Manchester-by-the-Sea, and Essex. It is also notable that, SeniorCare Inc, a Massachusetts Aging Services Access Point, serves as the backbone agency for ADFCA. For SeniorCare and the communities of Cape Ann, it was most efficient and effective to begin by integrating age- and dementia friendly. The integration of the two movements allows ADFCA to better leverage resources and eliminate redundancy. It allows the region to build a broader network of support and involvement for their overall mission. The collective impact framework and AARP’s Better Together report also proved fruitful in initially planning the integrated approach. The UMass Boston, Gerontology Institute worked closely with the team on community assessment providing tools and resources. Lastly, the MA Healthy Aging Community Profiles and the American Community Survey data are helpful in presentations and written work.

ADFCA is continually working to assure the age-friendly and dementia friendly movements have an equal presence in their work. The ADFCA Steering Committee includes a broad coalition of stakeholders representing the WHO/AARP domains of livability, Dementia Friendly America’s community sectors, older adults, and the care partners of individuals living with dementia. ADFCA actively works to include the voice of individuals living with dementia in their work and had initially hoped to have at least one individual living with dementia on the Steering Committee. However, it proved challenging to find a person living with dementia who is both willing and able to join the Steering Committee.

ADFCA has also been careful to weave age-friendly and dementia friendly questions into all aspects of its Community Assessment. This has included the Community Forums, Focus Groups, and Key Stakeholder interviews that were conducted by UMass Gerontology Institute and the community survey that SeniorCare developed. More information is available on the Age & Dementia Friendly Cape Ann website. 


The City of Marlborough has been actively implementing dementia friendly initiatives since the fall of 2015. While preparing to launch its dementia friendly efforts, the city’s Council on Aging (COA) director and colleagues from surrounding towns traveled to Minnesota to look at Minnesota’s Act on Alzheimer’s model.

Led by the COA, the city surveyed the community and announced the survey’s results, which mostly pertained to the need for education and training around dementia. The city set up its Dementia Friendly Marlborough website and established action teams to help train staff at Marlborough City Hall, first responders, and election workers on Alzheimer’s/dementia awareness. The action teams also raised awareness and trained members of the city’s business community.  Additionally, and the city’s police department set up a dementia registry.

In 2015, Marlborough didn’t feel there were enough local resources and momentum tied to a broader age-friendly focus, so its approach focused solely on becoming more dementia friendly.  Upon seeing the work of the Massachusetts Healthy Aging Collaborative and Massachusetts Councils on Aging, the COA decided to add a broader age-friendly focus to the dementia friendly efforts. Additionally, when the governor announced that Massachusetts had become an age-friendly state, Marlborough’s mayor wanted to make sure the city became an age-friendly community. The city was designated age-friendly in July of 2018. The support and engagement of the local government was crucial to making this integration possible.

Marlborough decided to focus on age-friendly “walkability,” specifically making it more accessible for residents to walk to the senior center from the adjacent park. AARP’s resources proved helpful in this effort. The same dementia friendly action team was kept to work on this age-friendly effort as it has broad, multi-sector representation. Their Department of Public Works Commissioner is very involved in this effort. To keep morale and momentum going, the action team has an appreciation event every 2 or 3 meetings to celebrate their successes.


The City of Boston was designated as age-friendly in 2014 and has been actively implementing dementia friendly initiatives since 2015. Despite starting at different times, the Age-Friendly Boston Action Plan makes it clear that the age- and dementia friendly movements are very much integrated and aligned. While there was an initial hesitation to integrate the two movements, stakeholders were convinced that an integrated approach would help the city leverage the efforts of both movements into its city planning. With multiple planning initiatives taking place in the city, the timing was perfect to highlight the benefits of integrating the age- and dementia friendly movements.

The city’s multi-faceted action plan reflects an aligned strategy with the World Health Organization’s (WHO’s) 8 Domains of Livability associated with the age-friendly movement and threads dementia throughout each theme. In addition to the 8 domains, Age-Friendly Boston elevated three overarching “Topics of Interest”: social isolation, economic insecurity, and dementia which are embedded throughout the action plan. In addition, the Age-Friendly Boston team within Boston’s Age Strong Commission has a staff person dedicated to Dementia Friendly Boston. Helpful resources for integration included the  Dementia Friends Massachusetts program, the Dementia Friendly Massachusetts leadership team,  Alzheimer’s Disease International, Alzheimer’s Research UK, and Dementia Australia. 

As part of its integrated age- and dementia friendly work, the city created an Age- and Dementia-Friendly Business Checklist and a pilot designation for age- and dementia friendly businesses. For more information about Boston’s age- and dementia friendly work, see Age-Friendly Boston.

Minuteman Advisory Group on Inter-local Coordination (MAGIC)

The Metropolitan Area Planning Commission is the largest planning region in Massachusetts and is broken up into 8 sub-regions. One is the “MAGIC” sub-region, which consists of about a dozen communities northwest of Boston.

The MAGIC sub-region became the first all-suburban group of communities that collectively joined the AARP/WHO Network of Age-Friendly Communities. Towns in the area entered the Age-Friendly Community network on an individual basis between February and early May of 2018.

Regional efforts like MAGIC tend to be led by one or two cities that serve as “anchor” communities. Because these anchors usually serve as a hub of resources, transportation, and healthcare, they spearhead the effort and convene participants from surrounding towns.

The MAGIC sub-region will be focused on age-friendly housing and transportation at the regional level while each town in the area will be individually pursuing an age-friendly designation. Some are also integrating dementia friendly efforts into their age-friendly work.

To encourage further integration of age- and dementia friendly work regionally, the Massachusetts Healthy Aging Collaborative co-hosted a “learning community” forum with local legislators that consisted of the MAGIC communities and bordering communities to the west that are all engaged in dementia friendly work. Most of the communities were represented along with organizational partners and local law enforcement to discuss their current work and goals for the future. The group will continue to meet periodically to network and share updates, and also discuss how they can integrate both age- and dementia friendly efforts.


Age-Friendly Berkshires (AFB) was accepted into the AARP/WHO Network of Age-Friendly Communities as a county (Berkshire County) in June 2015 and built a coalition of over 40 individuals, businesses, community organizations and local governments, across a 32-community region. One partner organization within AFB is the Berkshires Alzheimer’s Partnership, a voluntary network of dementia care and support providers, including individual care partners and advocates. The Partnership has been a helpful advisor for the larger group, ensuring that people living with dementia were considered throughout the development of the Age-Friendly Action Plan’s goals and strategies. The choice to keep dementia friendly efforts as an integral part of AFB was deliberate – just as aging is a shared experience, so too has dementia affected many in the community. One overarching goal in the Age Friendly Berkshires Action Plan is to “Incorporate Dementia Friendly precepts into AFB programs, as appropriate.”

While there was initial reluctance to integrating the two movements, both AFB and Dementia Friendly Berkshires (DFB) committed to the goals established in the regional Action Plan, which “included DF precepts in all things.” Through a series of personalized, one-on-one meetings, conferences and other appeals, both organizations re-committed to aligning their missions and working to support one another to have the greatest, collective impact, on behalf of older adults in the region.  

One useful tool the Age-Friendly Berkshires coalition has developed is a set of Checklists. The checklists contain a set of questions or suggestions, intended to spur thinking and action to begin “thinking age- and dementia friendly.”  Answering those questions or following a suggestion, will help users modify programs, products or services to be more appropriate, comfortable or supportive for residents as they age.

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