Design and Efficacy of Localized Non-Pharmacological Cognitive Materials: A Participatory Card-Game Intervention for Older Adults With Dementia in Taiwan

Non-pharmacological interventions are widely recognised as essential components of dementia care. However, many cognitive activities lack cultural relevance and are difficult to integrate into everyday care practice. Design-driven approaches that emphasise cultural localisation and feasibility may offer an alternative pathway for meaningful engagement. To address this, this study employed a qualitative, practice-based design to develop and evaluate a culturally localised cognitive card-game intervention for older adults living with dementia. The intervention was implemented in routine care settings and examined through participant observation, staff interviews, and participation records, with data subsequently analysed thematically with a focus on engagement, social interaction, and feasibility. Three interrelated themes emerged from the analysis: (1) cultural familiarity as a catalyst for engagement, (2) social interaction and emotional expression through shared play, and (3) feasibility and adaptability within everyday care routines. Specifically, participants demonstrated sustained attention and active involvement, while care staff reported that the intervention was easy to use and compatible with existing practice. Cultural references embedded in the card content also appeared to facilitate communication and shared experiences among participants with varying cognitive abilities. These findings suggest that culturally localised cognitive materials can support meaningful engagement and social interaction in dementia care without relying on complex or resource-intensive interventions. By foregrounding cultural relevance and design feasibility, this study contributes to the growing body of non-pharmacological dementia research and highlights the value of design-driven approaches situated in real-world care contexts.