Developing a hierarchical priority framework for therapeutic landscapes in age-friendly community parks: a systematic review

As aging-in-place policies gain global adoption, community parks are vital for older adults' health. Therapeutic landscapes offer a promising framework for understanding how park environments support well-being. However, how these dimensions contribute to therapeutic outcomes and whether they operate through a structured hierarchy remain theoretically underdeveloped. The aim of this systematic review is to determine how therapeutic landscape dimensions collectively and sequentially support geriatric health. Following PRISMA guidelines, a systematic search of Web of Science and Scopus synthesized data from 25 studies across 14 countries. Two principal findings emerge. First, the interaction between older adults and park environments emerges as a cyclical process where users actively shape their therapeutic experiences. Second, a Hierarchical Priority Framework is proposed in which physical, social, activity and immediate health features form a foundation leading to the symbolic dimension. This symbolic level represents the highest therapeutic experience, reachable only through sustained engagement. The main conclusion establishes that physical infrastructure alone cannot sustain therapeutic value. Park design and policy must continuously support both physical spaces and social activities to maintain long-term health benefits.