Social Prescribing and Dementia in Viet Nam: Where Could Community-Connected Support Add Value, and What Safeguards Are Needed?

Social Prescribing and Dementia in Viet Nam: Where Could Community-Connected Support Add Value, and What Safeguards Are Needed?

Category: Evidence & Evaluation

An older adult who once enjoyed meeting friends, attending community gatherings and taking part in familiar activities gradually begins to withdraw. Remembering appointments has become difficult, conversations sometimes feel confusing, and family members are increasingly concerned about the person's safety. Following a dementia diagnosis, relatives may become more protective, even when the individual still wants to participate in everyday community life.

Medical follow-up and appropriate dementia care remain essential. But another question deserves attention: what would help this person continue doing things that matter to them, maintain relationships and remain connected to the community?

This is where social prescribing may have a role. By helping people access appropriate non-clinical activities and community resources, social prescribing could complement dementia care, particularly when participation has become difficult because of cognitive changes, reduced confidence, practical barriers or limited access to suitable support.

However, dementia presents challenges that cannot be addressed through an ordinary community referral alone. Cognitive impairment may affect communication, understanding, memory, orientation and decision-making. Some people require substantial assistance, while others remain relatively independent. Family involvement can be valuable, but it also raises questions about autonomy and consent. Community organizations may offer meaningful opportunities without necessarily having the competence or resources to support more complex needs.

For Viet Nam, the relevant question is therefore not whether everyone living with dementia should receive a social prescription. It is where community-connected support could genuinely add value to everyday participation, what adaptations may be needed, and how such support can remain safe, person-centered and appropriately connected to professional care.

Dementia changes participation, but it does not erase the person

Dementia is a syndrome caused by different diseases and conditions affecting the brain. It can impair memory, thinking, communication, behavior and the ability to perform everyday activities. Alzheimer's disease is the most common underlying cause, but dementia also includes vascular dementia, dementia with Lewy bodies, frontotemporal dementia and other forms.

According to the World Health Organization's July 2026 dementia fact sheet, approximately 57 million people worldwide were living with dementia in 2021, with more than 60% living in low- and middle-income countries. Dementia is more common at older ages, but it is not an inevitable consequence of aging and can also affect younger adults.

Its effects vary considerably between individuals. Someone with mild dementia may continue managing many daily activities while needing occasional assistance with appointments, transportation or unfamiliar environments. Another person may experience significant communication difficulties, impaired judgment, distress or increasing dependence on others. The type of dementia, its progression, other health conditions, personal circumstances and available support can all influence what participation remains possible.

Yet a diagnosis does not remove someone's interests, relationships, identity or desire for meaningful experiences. A former teacher may still enjoy discussing books. Someone who spent years gardening may find pleasure in working with plants. A person who values music, cultural activities or familiar social gatherings may continue enjoying those experiences even when remembering details becomes difficult.

These activities should not automatically be described as treatment. Their value may lie in helping someone remain connected to familiar interests, relationships and aspects of life that matter to them.

This distinction is central to responsible social prescribing. The goal should not be to occupy a person with dementia simply because they have a diagnosis. It should be to identify meaningful opportunities for participation that reflect their preferences, abilities and circumstances.

What does the evidence actually tell us in 2026?

Recent research provides useful insights, but the findings require careful interpretation because studies use different definitions of social prescribing and examine different types of interventions.

A 2025 complex-intervention systematic review by Papavasiliou and colleagues, published in Health Expectations, examined 49 studies concerning people living with dementia in the United Kingdom. The review identified interventions involving cognitive, educational, psychosocial, physical, community and complementary activities, delivered through healthcare services, charities and other support arrangements.

The authors reported potentially beneficial findings in areas such as mood, independence and aspects of well-being. However, the interventions were highly varied, with some representing individual activities and others involving broader programs or combinations of services. Of the 49 studies, 31 used qualitative methods, 11 used mixed methods, five were quantitative studies and two were classified as randomized controlled trials. The review also identified challenges involving intervention suitability, accessibility and the resources required for implementation.

These findings suggest that community-connected interventions may offer benefits for some people living with dementia, but they do not establish the effectiveness of social prescribing as a standardized model.

The distinction became clearer in a 2026 scoping review by Carmody, Middleton and Chadborn, published in the Journal of Integrated Care. The researchers specifically examined social prescribing for people with dementia where the pathway included a link worker and person-centered care planning.

Of 126 records identified and screened, only six articles met the inclusion criteria. Two of these articles represented different reports from the same study. The included publications provided limited information about the precise role of link workers when supporting people with dementia. The authors also identified insufficient discussion of whether dementia-related impairments require additional training, specialized resources or modifications to conventional social-prescribing approaches.

The difference between the 49 studies in the broader 2025 review and the six articles in the more narrowly defined 2026 review is important. It does not mean the earlier research was invalid. Rather, the evidence on community-based interventions for people with dementia is considerably broader than the evidence specifically examining structured social prescribing with link-worker involvement.

A third perspective comes from a systematic review published by Wang and colleagues in February 2026 in Alzheimer's & Dementia: Behavior & Socioeconomics of Aging. This review examined psychosocial interventions intended to increase social participation among people with dementia living in the community.

Across 15 controlled trials involving 1,965 participants, the findings were largely inconsistent or inconclusive. Only one study reported a positive efficacy finding, involving an immediate reduction in loneliness following a group intervention using social robots. A high-quality rehabilitation study reported no benefit for the outcomes examined, while other approaches involving physical activity, cognitive interventions and arts-based therapies produced mixed results. Some pilot interventions were considered feasible or acceptable, but this did not establish their effectiveness.

This third review was not specifically about social prescribing. Its relevance is that even for the broader objective of improving social participation among people living with dementia, controlled evidence remains limited.

More recent intervention research offers additional insight. In June 2026, Rettich and colleagues published a randomized controlled trial in the Journal of Public Health examining museum-based activities for people with dementia and their caregivers in Germany. The study involved 58 pairs of participants, with each pair consisting of a person living with dementia and an informal caregiver. Participants were assigned to guided or unguided museum visits.

The researchers reported reductions in depressive symptoms among people living with dementia across both groups, without a significant difference between guided and unguided visits. Caregiver health-related quality of life improved in the guided group, but the intervention did not demonstrate a sustained reduction in caregiver burden. Although the findings suggest that accessible cultural activities may provide psychosocial benefits, the study did not evaluate a complete social-prescribing pathway with link-worker involvement. Because both groups attended museum visits, it also cannot establish the benefits of museum participation compared with no visits.

This illustrates why it is important to distinguish promising evidence for a community activity from evidence supporting the effectiveness of social prescribing as a coordinated service model.

Taken together, the available research supports a cautious interpretation. Community activities and personalized navigation may create meaningful opportunities for some individuals, but social prescribing has not yet been established as a standardized intervention with demonstrated effectiveness in dementia care.

There is insufficient evidence to conclude that social prescribing prevents dementia, slows cognitive decline, alters disease progression, consistently reduces loneliness or produces reliable healthcare cost savings.

That does not make the approach irrelevant. It means that claims about its benefits should remain proportionate to the evidence, and future implementation should be designed to answer questions that existing research has not yet resolved.

Community participation is not automatically social prescribing

Someone living with dementia may benefit from attending a community activity without receiving social prescribing. This distinction matters because some studies use broad definitions that include arts programs, exercise, peer support, cognitive activities and other non-clinical interventions.

These activities can be valuable, but their existence alone does not establish that a social-prescribing pathway is operating.

For someone living with dementia, an appropriate pathway might begin when a healthcare professional or another suitable provider recognizes that the person is having difficulty accessing meaningful community participation. A navigator or appropriately qualified professional could then work with the individual to understand their goals, identify suitable resources, address barriers and support a connection where needed.

The distinctive contribution of social prescribing would lie partly in helping someone reach support that might otherwise remain inaccessible.

For example, a person may already know about a local cultural group but feel uncertain about attending because they are worried about becoming confused or finding their way home. Simply providing the group's address may not resolve those concerns. An appropriate introduction, clear travel arrangements, a familiar contact person or assistance during an initial visit may make participation more realistic.

Whether these additional elements improve outcomes for people living with dementia remains a question for evaluation rather than an established conclusion.

There is also a difference between community participation and professionally delivered dementia interventions. An arts activity, for example, should not automatically be described as clinical therapy. Similarly, a general community cognitive activity should not be confused with a structured cognitive stimulation therapy program delivered according to appropriate professional standards.

Social prescribing may help people access suitable services, but it should not be used to relabel every supportive or therapeutic activity as a social prescription.

Meaningful participation should begin with the person's interests

One of the most important questions in dementia-related social prescribing is whether the proposed activity genuinely matters to the individual.

It can be tempting to begin with a list of services: memory groups, music sessions, arts programs, walking groups, social clubs or caregiver support activities. But a diagnosis does not tell us which activities someone will enjoy.

A person may welcome a group specifically designed for people living with dementia because it offers understanding and a less judgmental environment. Another may prefer to continue attending an ordinary community activity with appropriate support rather than join a diagnosis-specific program.

Both preferences deserve consideration.

The World Health Organization's 2021 toolkit, Towards a Dementia-Inclusive Society, emphasizes helping people living with dementia remain active and valued members of their communities. This approach supports inclusion rather than treating dementia as an automatic reason for withdrawal from everyday social life.

Where appropriate, community participation should offer opportunities to make choices, contribute, maintain familiar roles and interact with others in ways that reflect the person's interests and abilities.

Someone who previously enjoyed cooking might value helping with a familiar community activity rather than simply attending as a recipient of support. A person who enjoys music may prefer singing familiar songs with others to participating in an unfamiliar cognitive exercise program.

These are illustrative possibilities, not interventions whose effectiveness has been established in Viet Nam.

A meaningful outcome might be returning to a familiar gathering, maintaining a friendship, feeling comfortable among others or being able to take part in an activity without unnecessary distress.

In dementia care, meaningful participation should not be confused with simply keeping someone busy.

Cognitive changes may require a different approach to navigation

The social-prescribing process itself may need adaptation for people living with dementia.

A conventional pathway may rely on telephone calls, written information, self-directed appointments and the individual's ability to remember arrangements. These assumptions may not hold for someone experiencing memory difficulties, impaired communication or reduced confidence in unfamiliar situations.

A qualitative study published by Di Lorito and colleagues in PLOS One in January 2025 explored the experiences of 24 social prescribers working with people with dementia and their families in England. Participants described challenges involving communication, motivation, engagement, establishing trust and managing the boundaries of ongoing support.

The researchers identified possible strategies involving additional dementia-specific training, more opportunities for face-to-face contact and stronger coordination between healthcare and community services.

These findings are valuable because they highlight difficulties that may not be visible when examining referral numbers alone. However, the study reported the experiences and perceptions of social prescribers; it did not demonstrate the effectiveness of a particular navigation model.

In practice, someone living with dementia may benefit from shorter explanations, additional time to respond, consistent contact with a familiar navigator or reminders provided through an agreed method. An introduction may need to take place in person rather than through a telephone call. Participation may also become easier when someone knows what to expect and can become familiar with the environment gradually.

These adjustments should not be applied mechanically. Some people may require very little additional assistance, while others may need substantial support or a different service altogether.

A navigator should not assume that someone has declined support merely because communication was difficult during an initial conversation. Equally, a person should not be pressured to participate simply because a professional or family member believes an activity would be beneficial.

The individual's response may also change over time. Someone who initially welcomes an activity may later become uncomfortable, tired or unwilling to continue. A person-centered approach should remain attentive to these changes rather than treating an earlier agreement as a reason to continue regardless of the person's current experience.

Another important issue is the duration of navigation support. The 2026 review by Carmody and colleagues identified a potential mismatch between time-limited social-prescribing services and the changing needs associated with a progressive condition such as dementia.

A single introduction may be sufficient for some people, while others may later need additional assistance because their circumstances or abilities have changed. This does not mean a link worker should automatically become a long-term dementia care manager. It means that the pathway should be clear about the duration and boundaries of navigation, the possibility of re-referral and how people can access appropriate support when their needs change.

The objective is to support meaningful choice and participation while recognizing that difficulty communicating, difficulty understanding and unwillingness to participate are not necessarily the same thing.

Family involvement can help without replacing the individual's preferences

Family members often play an important role in dementia care in Viet Nam. They may help arrange appointments, provide transportation, support communication, manage practical difficulties and accompany relatives to community activities.

This involvement can make community-connected support more accessible. A family member may understand longstanding interests, recognize situations that cause distress or help maintain a familiar routine.

However, family involvement should not automatically replace the individual's own preferences.

A spouse may want someone to attend a group because they believe it will reduce isolation. Adult children may prefer that an older parent remain at home because they are concerned about safety. The person living with dementia may have different priorities.

These differences require sensitive discussion rather than an assumption that one perspective should always prevail.

A person-centered pathway should seek the individual's views directly, using appropriate communication support. Family members may contribute valuable information, but their involvement should reflect the person's wishes and any applicable legal arrangements.

Family caregivers may also need support in their own right. The World Health Organization's iSupport for Dementia provides educational resources and practical guidance for people caring for someone living with dementia. Such resources can form part of a broader support system, although caregiver education should not automatically be classified as social prescribing.

The needs of caregivers and people living with dementia are closely related, but they are not identical. A community connection should not be considered successful solely because it reduces practical difficulties for a family member. It should also consider whether the person living with dementia experiences the support as appropriate, comfortable and meaningful.

A dementia diagnosis does not automatically remove decision-making rights

Consent and autonomy require particular attention when developing social-prescribing pathways for people living with dementia.

Dementia may affect someone's ability to understand information, consider options or communicate a decision. However, the extent of these difficulties varies, and a diagnosis alone does not establish that the person lacks legal capacity.

Under Viet Nam's Civil Code No. 91/2015/QH13, Article 22 regulates the judicial declaration of loss of civil act capacity. Such a declaration requires a court decision based on the applicable legal conditions and forensic psychiatric assessment.

Article 23 separately addresses adults who have difficulties in cognition or controlling their behavior but have not reached the threshold for loss of civil act capacity. In these circumstances, the court may issue the relevant declaration and appoint a guardian, specifying the guardian's rights and responsibilities according to the law.

These are distinct legal circumstances. A clinical diagnosis of dementia does not, by itself, constitute a court declaration of incapacity or automatically authorize family members to make every decision on the person's behalf.

For voluntary social-prescribing activities, professionals and community partners should therefore avoid assuming that family agreement automatically replaces the individual's own wishes or any legally required consent.

The person should be given an appropriate opportunity to understand the proposed activity, express preferences and participate in decisions to the extent possible. Information may need to be presented differently, and the individual's ability to understand a particular decision may vary depending on its complexity and their current condition.

Where legally recognized representation or guardianship applies, the scope of that authority must be respected. The legal requirements for participating in an activity, entering an agreement or consenting to personal data processing may differ according to the circumstances.

Privacy also remains important. Information about a dementia diagnosis, cognitive difficulties, family relationships or health status should not be disclosed more widely than necessary for a legitimate purpose.

Viet Nam's Law No. 91/2025/QH15 on Personal Data Protection and Decree No. 356/2025/ND-CP, both effective from 1 January 2026, establish requirements relevant to handling personal information, including health-related and other sensitive data.

A community organization may need to know that someone requires assistance with communication or orientation. It does not automatically need access to the person's complete medical history.

The practical principle is to support the individual's participation in decision-making wherever possible, respect legally established arrangements and avoid treating dementia as an automatic loss of autonomy.

Community support must remain connected to professional dementia care

Social prescribing should complement appropriate healthcare and professional support, not replace them.

Dementia assessment and management may require qualified healthcare professionals, including those with expertise in neurology, geriatrics, psychiatry, primary care or other relevant disciplines. Needs may include diagnosis, medication review, management of coexisting conditions, rehabilitation, psychological support, assessment of daily functioning and ongoing care planning.

Community activities do not replace these responsibilities.

This distinction becomes particularly important when new symptoms or substantial changes occur. Sudden confusion, rapidly worsening attention, marked behavioral changes, new mobility difficulties or an acute deterioration in functioning should not automatically be attributed to dementia progression.

Such changes may indicate delirium or another medical problem requiring prompt assessment. Pain, infection, medication effects, depression, sensory impairment and other conditions may also influence cognition, behavior and participation.

International clinical guidance, including NICE Guideline NG97 on dementia assessment and management, emphasizes the importance of assessing potentially treatable causes of cognitive and behavioral changes. The guideline was last reviewed on 24 October 2025, when NICE decided that an update to its recommendations was not required.

A community facilitator or navigator is not expected to diagnose these conditions. Their role should include recognizing when a concern is beyond the scope of community support and ensuring that the person can access appropriate professional assessment.

Activities involving physical exertion may also require consideration of falls risk, mobility limitations, cardiovascular conditions or other relevant health problems. Where professional rehabilitation or individualized clinical assessment is indicated, a general community exercise group should not be presented as an equivalent alternative.

For people living with dementia, a responsible pathway should understand which needs community participation may complement and which require professional care.

What dementia-specific safeguards are needed?

Dementia-related social prescribing requires safeguards that reflect the individual's abilities, the proposed activity and the environment.

Someone experiencing difficulty with orientation may need clear arrangements for arriving at and leaving an activity. A person with impaired balance may require an accessible venue and appropriate mobility support. Another individual may become distressed in crowded, noisy or unfamiliar surroundings.

These considerations should not automatically exclude people living with dementia from participation. Instead, they should help determine whether an activity is suitable and what reasonable adjustments may be needed.

Community organizations should understand the limits of their responsibilities before accepting referrals. Staff and volunteers may need appropriate preparation in communicating with people experiencing cognitive difficulties, recognizing distress, responding to disorientation and seeking professional assistance when concerns arise.

For activities involving someone who may become lost or disoriented, practical arrangements may be needed concerning transportation, supervision, agreed contact persons and responses to an unexpected absence. Such arrangements should be proportionate to the person's circumstances and developed with appropriate consent or legal authorization.

Safeguarding also involves recognizing possible abuse, neglect, exploitation and inappropriate restrictions on personal freedom. People living with dementia may face particular vulnerabilities, but safety should not be pursued through unnecessarily restrictive practices or automatic exclusion from ordinary community life.

The aim is not to eliminate every conceivable risk by preventing participation. It is to assess foreseeable risks, make reasonable adjustments, respect the person's preferences and ensure that appropriate assistance is available.

This balance can be difficult. A family may understandably be concerned about someone attending an unfamiliar activity. A community organization may worry that it lacks the skills to support a person who becomes confused or distressed. The solution should not automatically be to deny participation, nor should it be to ask unprepared volunteers to assume responsibilities beyond their competence.

Sometimes a modest adjustment may make participation possible. In other circumstances, a different activity, additional professional support or reassessment of the individual's needs may be necessary.

A referral should proceed only when the receiving organization can reasonably provide the support expected of it. Where participation is not appropriate at that time, the person should not simply be left without further options.

Dementia-inclusive communities and social prescribing are related, but not identical

The World Health Organization promotes dementia-inclusive communities as places where people living with dementia can continue participating in everyday life with dignity and appropriate support.

This may involve improving public understanding, reducing stigma, making environments easier to navigate and supporting participation in ordinary social and community activities.

Such initiatives are relevant to social prescribing because a referral cannot create a meaningful connection if the receiving environment is inaccessible, unwelcoming or unable to respond appropriately.

However, a dementia-inclusive community initiative is not automatically a social-prescribing program. The former may focus broadly on awareness, environments, attitudes and participation. The latter involves connecting individuals with appropriate support through a defined process that may include assessment, navigation and follow-up.

Both approaches can complement each other.

For example, a cultural center with an accessible environment and staff familiar with dementia may offer a suitable activity. A healthcare professional or community navigator may then help someone who wishes to participate but faces practical or communication barriers.

The activity and the navigation pathway perform different functions.

It is also important not to assume that a dementia-specific service is always preferable. Some people may feel more comfortable in activities designed for individuals with similar needs. Others may wish to remain involved in familiar community activities without being separated from people who do not have dementia.

The appropriate choice should reflect the individual's preferences, abilities and the suitability of the environment.

What does the Vietnamese context tell us?

Viet Nam's aging population makes dementia an increasingly relevant issue for healthcare, long-term care and community support. However, the country should not be treated as having a uniform dementia-care environment.

Access to specialist assessment, rehabilitation, social support and suitable community activities may differ between localities and healthcare settings. Family involvement can be substantial, but family resources, availability and preferences also vary.

These differences matter when considering whether a social-prescribing pathway would be feasible.

Viet Nam already has a policy framework relevant to older people's participation and support. Law No. 39/2009/QH12 on the Elderly, as amended, recognizes rights and responsibilities relating to older people's healthcare and participation in social and community life.

More recently, Decision No. 383/QD-TTg, issued on 21 February 2025, approved the National Strategy on Older Persons to 2035, with a vision to 2045. Its objectives for 2025–2030 include strengthening opportunities for older people's participation in community activities and improving support for families caring for older people experiencing memory decline, severe disabilities and other significant difficulties.

This policy direction is relevant to dementia-inclusive support. However, a national strategy and its targets should not be confused with evidence that suitable services are available everywhere or that a national dementia social-prescribing program has already been established.

The professional social-work framework is also relevant. Circular No. 51/2024/TT-BYT, effective from 1 March 2025, regulates social-work activities in medical examination and treatment establishments licensed to operate as hospitals. Decree No. 110/2024/ND-CP on Social Work establishes broader requirements for social-work practice, with the applicable practice registration certificate becoming mandatory from 1 January 2027 for practitioners covered by its provisions. Circular No. 29/2026/TT-BYT, effective from 25 August 2026, further regulates social-work practice and the updating of professional knowledge.

These instruments do not create a nationally standardized social-prescribing service for people living with dementia. They do mean that any proposed navigation function should be considered in relation to existing professional responsibilities rather than introduced as an entirely separate role without examining the applicable requirements.

Not everyone living with dementia is an older adult. People with young-onset dementia may have different concerns involving employment, income, family responsibilities and social identity. Programs designed specifically for older people should not automatically be assumed to address those needs.

For Viet Nam, the most credible opportunity is to explore how community-connected support could complement existing healthcare, dementia care and social-work arrangements, while recognizing that resources and implementation capacity may be uneven.

What should an early Vietnamese pilot seek to understand?

An early dementia-related social-prescribing pilot in Viet Nam should not attempt to serve everyone with cognitive impairment or cover all stages of dementia.

A more practical starting point would be a clearly defined population, a specific difficulty with community participation and a limited group of receiving organizations whose suitability has been assessed.

For example, a healthcare organization might explore a pathway for selected adults with an established dementia diagnosis who wish to maintain or resume meaningful activities but face barriers involving communication, confidence, transportation or unfamiliar environments.

Eligibility should not depend solely on a diagnostic label or disease stage. The person's actual needs, preferences, decision-making arrangements, safety considerations and available support should determine whether the pathway is appropriate.

People living with dementia and family caregivers should contribute to the design, alongside healthcare professionals, appropriate social-work personnel, navigators and community partners. The involvement of people living with dementia is particularly important because professional and family assumptions about what constitutes a good outcome may not always reflect their experience.

An important question is whether navigation adds value beyond providing information about an activity. Does an introduction from a familiar professional make participation more comfortable? Do reminders or assistance during an initial visit help someone attend? Can community staff make reasonable adjustments without being asked to perform clinical or regulated professional tasks?

Another question is how much continuing assistance may be needed. A single introduction may be sufficient for some people, while others may require additional contact or support as their circumstances change. The appropriate duration and intensity of navigation remain important areas for research.

These are practical questions that can be examined in a pilot. They should not be treated as benefits already established by evidence.

The receiving organizations should also be involved before referrals begin. An activity may appear suitable in a directory but be difficult for someone who experiences disorientation, struggles with group instructions or becomes distressed in an unfamiliar environment.

The objective should be to test whether a specific approach to community connection is feasible, acceptable and safe under the conditions of a particular setting, while identifying what adaptations and resources are actually necessary.

Evaluation should preserve the person's own perspective

The evidence gaps identified in recent reviews have important implications for evaluation.

A dementia-related social-prescribing pilot should not be judged primarily by the number of referrals made, the number of activities listed or attendance at an initial session. These measures describe activity, but they do not establish whether the pathway has improved someone's experience of everyday life.

Evaluation should consider whether people reach activities that matter to them, whether they feel comfortable and included, whether participation can be maintained and whether the necessary adjustments are practical and acceptable.

Relevant outcomes may include meaningful social participation, perceived connection, enjoyment, well-being, autonomy and the ability to continue valued activities. Where appropriate, caregiver and community-provider experiences may offer additional insight.

However, the person's own perspective should not disappear simply because cognitive impairment makes conventional questionnaires difficult.

Some individuals may be able to describe their experiences directly with suitable communication support. Others may need alternative assessment methods or supplementary observations from people who know them well. Proxy reports can provide useful information, but they should not automatically be considered equivalent to the individual's own experience.

Outcome measures also need to be appropriate to the person's cognitive abilities, language and cultural context. Instruments developed in other countries should not be assumed to be valid for Vietnamese populations without appropriate adaptation and evaluation.

Safety outcomes deserve attention as well. These may include distress during participation, transportation difficulties, unsuitable referrals, safeguarding concerns and situations in which community organizations cannot provide appropriate support.

The resources needed to maintain the pathway also matter. Navigator time, family involvement, transportation assistance and the workload placed on community facilitators can all influence feasibility and cost.

A small pilot may demonstrate acceptability, feasibility or potentially meaningful changes. It cannot automatically establish that social prescribing caused improvements in cognition, delayed disease progression, reduced hospital admissions or produced cost savings.

The aim should be to understand whether the pathway helps people participate in ways that matter to them, for whom it works, under what circumstances and with what level of support.

What should we not assume?

Several assumptions require particular caution.

Not everyone living with dementia wants or needs a diagnosis-specific activity. Nor should a diagnosis be treated as automatic evidence that someone cannot express preferences or participate in decisions.

Family members may offer essential support, but their goals do not always match the individual's wishes. Familiar community activities are not automatically safe or accessible, and volunteers should not be expected to manage complex clinical or social-care needs without appropriate competence and authority.

Promising findings from arts, exercise, peer support or other psychosocial interventions should not be interpreted as proof that a complete social-prescribing pathway is effective.

We should also avoid assuming that an intervention developed in the United Kingdom or another high-income setting will have the same accessibility, cultural fit or outcomes in Viet Nam. Differences in healthcare organization, professional roles, community resources and family arrangements may influence whether a pathway can work as intended.

Most importantly, social prescribing should not be presented as a treatment for dementia itself. Community participation may be meaningful for personal, social and emotional reasons, but there is currently insufficient evidence that social prescribing prevents dementia, slows cognitive decline or changes the underlying course of the condition.

These limitations do not diminish the importance of community inclusion. They help define where responsible implementation should begin and what future research needs to establish.

Community connection should support the person, not simply respond to the diagnosis

Dementia care involves clinical assessment, treatment where appropriate, rehabilitation, support for daily functioning and assistance with changing care needs. These responsibilities remain essential as the condition progresses.

At the same time, people living with dementia continue to have interests, preferences, relationships and a place within their communities. Losing access to familiar and meaningful activities can affect more than the number of social contacts someone has. It may also affect confidence, identity and the sense of belonging.

Social prescribing may help some individuals maintain these connections, particularly where personalized navigation can address barriers that would otherwise prevent participation. But its potential depends on the suitability of community resources, the adjustments available, the competence of those providing support and the ability to remain connected to professional care.

For Viet Nam, the central question should therefore not be how to prescribe more community activities to people with dementia. It should be what matters to this person, what would make meaningful participation possible, and how healthcare and community partners can help without compromising autonomy, safety or appropriate professional care.

This places the individual, rather than the diagnosis or the availability of a program, at the center of the pathway.

If that distinction is maintained, social prescribing could become a useful complement to dementia-inclusive care in Viet Nam. Its role, however, should be developed through careful local implementation and evaluation, with conclusions guided by evidence rather than assumptions about what community participation can achieve.

References

1. World Health Organization. Dementia. WHO Fact Sheet. Updated 3 July 2026.

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3. Carmody I, Middleton A, Chadborn NH. Social prescribing with link worker for dementia: a scoping review. Journal of Integrated Care. Published online 2026. doi:10.1108/JICA-04-2025-0029.

4. Wang Z, Livingston G, Shi P, Rodgers F, Hassiotis A, Sommerlad A. Psychosocial interventions to increase social participation for people with dementia living in the community: A systematic review. Alzheimer's & Dementia: Behavior & Socioeconomics of Aging. 2026;2(1). doi:10.1002/bsa3.70068.

5. Rettich A, Wächter M, König L, Petermann J, Bothur M, Voigt K. Exploring museums as non-medical treatment for dementia: results of a randomized controlled trial. Journal of Public Health. Published online 18 June 2026. doi:10.1007/s10389-026-02831-y.

6. Di Lorito C, Poole M, Rait G, Samsi K, McComiskie L, Robinson L, et al. What are the challenges that social prescribers face when supporting people within dementia and how can these be addressed? A qualitative study. PLOS One. 2025;20(1). doi:10.1371/journal.pone.0317749.

7. World Health Organization. Towards a Dementia-Inclusive Society: WHO Toolkit for Dementia-Friendly Initiatives. Geneva: World Health Organization; 2021.

8. World Health Organization Regional Office for the Western Pacific. Dementia Toolkit for Community Workers in Low- and Middle-Income Countries: Guide for Community-Based Management and Care of People With Dementia. Manila: WHO Regional Office for the Western Pacific; 2018.

9. World Health Organization. iSupport for Dementia: Training and Support Manual for Carers of People With Dementia. Geneva: World Health Organization; 2019.

10. World Health Organization Regional Office for the Western Pacific. A Toolkit on How to Implement Social Prescribing. Manila: WHO Regional Office for the Western Pacific; 2022.

11. National Institute for Health and Care Excellence. Dementia: Assessment, Management and Support for People Living With Dementia and Their Carers. NICE Guideline NG97. United Kingdom; 2018. Last reviewed 24 October 2025.

12. National Assembly of Viet Nam. Civil Code No. 91/2015/QH13. Enacted 24 November 2015. Effective 1 January 2017.

13. National Assembly of Viet Nam. Law No. 39/2009/QH12 on the Elderly, as amended. Effective 1 July 2010.

14. Prime Minister of Viet Nam. Decision No. 383/QD-TTg approving the National Strategy on Older Persons to 2035, with a vision to 2045. Issued 21 February 2025.

15. Ministry of Health of Viet Nam. Circular No. 51/2024/TT-BYT on the implementation of social work in medical examination and treatment establishments. Effective 1 March 2025.

16. Government of Viet Nam. Decree No. 110/2024/ND-CP on Social Work. Effective 15 October 2024.

17. Ministry of Health of Viet Nam. Circular No. 29/2026/TT-BYT on social-work practice and updating professional social-work knowledge. Effective 25 August 2026.

18. National Assembly of Viet Nam. Law No. 91/2025/QH15 on Personal Data Protection. Effective 1 January 2026.

19. Government of Viet Nam. Decree No. 356/2025/ND-CP detailing certain articles and measures for implementation of the Law on Personal Data Protection. Effective 1 January 2026.

This article provides an educational and evidence-focused discussion of social prescribing and dementia in Viet Nam. It does not establish that a particular social-prescribing model has been validated for people living with dementia in Viet Nam, nor does it constitute medical or legal advice. Clinical decisions, professional responsibilities and legal requirements should be assessed according to the individual's circumstances and current Vietnamese law.