Farm-based therapeutic horticulture for people living with dementia: the Vicenza Farm Project.

Dementia is a major global health challenge, with wide-ranging psychosocial and relational impacts that call for supportive, everyday interventions alongside clinical care. While advances in Alzheimer's disease are promising, dementia includes multiple conditions, including young-onset forms, and existing pharmacological and non-pharmacological interventions still offer valuable but incomplete support, often leaving everyday psychosocial needs unmet for most people living with dementia. This Perspective describes the Vicenza Farm Project, a farm-based therapeutic horticulture program developed on social and educational farms of Northern Italy. The program offers weekly 3-h group sessions from March to October for around 8-10 participants, including people with young-onset dementia, facilitated by a multidisciplinary team of farmers, psychologists and trained volunteers. Activities follow a structured, replicable protocol that combines cognitive stimulation, seasonal gardening and farm tasks, shared breaks and closing reflection, with an emphasis on supported participation, personal agency and safe freedom. Drawing on qualitative and quantitative data from international literature on nature-based and care farming interventions, we outline how a farm-based therapeutic horticulture can help restore purpose, social connection and embodied identity while also animating rural spaces and reinforcing environmentally sensitive farming practices. We contrast the Italian policy framework of social agriculture, in which therapeutic horticulture is not yet recognized as a health intervention, with the more institutionalized Dutch model of green care farms, and we propose priorities for evaluation, integration into dementia pathways and long-term funding.