Human rights frameworks often presume a person who can clearly communicate choices, consistently express preferences, independently assert their will, and actively participate in decisions affecting their life. Yet many older persons live with forms of cognitive impairment that may affect memory, language, communication, orientation, judgment or executive functioning without erasing emotional life, subjective experience, relationships, values or the need for recognition as persons.

Cognitive impairment may gradually change how a person participates in conversations, relationships, social roles and decisions concerning everyday life. Too often, however, such changes are interpreted primarily through assumptions of incapacity, incompetence or diminished personhood. Older persons with cognitive impairment may therefore be spoken for rather than listened to, excluded from meaningful participation, or gradually displaced from positions of social visibility, symbolic adulthood and recognition as subjects of their own lives.

The consequences are not limited to formal loss of rights or severe abuse. Human dignity may also be undermined through subtle and everyday forms of paternalism, overprotection, infantilization, silencing, reduced expectations regarding participation, or failure to recognize fluctuating and relational forms of autonomy.

At the centre of this report lies a fundamental question:

• What do autonomy, participation and human dignity mean when cognition becomes vulnerable, fluctuating or impaired?

The report will be guided by the recognition that cognitive impairment does not erase personhood, voice, relational identity, emotional life, or entitlement to the full enjoyment of human rights. Rather than approaching autonomy as an all-or-nothing capacity, the report will seek to explore how participation, communication, expression of preferences and social recognition may continue to exist in supported, relational and context-dependent forms.

Particular attention will be given to how laws, policies, and practices by State and non-State actors have supported the full enjoyment of human rights by older persons, and what challenges they encounter, in relation to:

• voice, communication and supported expression of wishes and preferences;
  experiences of being ignored, spoken over, infantilized or socially erased;
• relational, fluctuating and context-sensitive forms of autonomy;
• participation in conversations, relationships and decisions affecting everyday life;
• social visibility, symbolic adulthood and recognition as persons;
• stigma, fear and assumptions associated with cognitive impairment;
• preservation of identity, continuity and meaningful belonging; and
• practices that sustain dignity, agency, participation and recognition.

The report will not seek to provide a medical or diagnostic analysis of cognitive disorders. Rather, it will examine cognitive impairment as a human rights issue affecting recognition, participation, autonomy, dignity and personhood in older age.

Key questions and types of input/comments sought

The Independent Expert welcomes submissions from States, national human rights institutions, civil society organizations, academics, healthcare and care professionals, international organizations, persons living with cognitive impairment, caregivers, families and other relevant stakeholders.

Inputs are welcome in relation to particular States or territories, as well as more general inputs concerning populations, regions or the international community as a whole.

Respondents are requested to limit their comments to a maximum of 2,500 words. Additional supporting materials, such as reports, academic studies and other background materials, may be annexed to the submission.

The following questions are intended to guide reflections on autonomy, participation, recognition and human dignity in the context of cognitive impairment in older age.

1. Voice, recognition and lived experience
   1. In what ways are older persons with cognitive impairment not heard, not recognized, or excluded from meaningful participation in everyday life?
      1. Examples: being spoken over, excluded from conversations or decisions, ignored in care settings, loss of social roles, diminished visibility in family or community life.
   2. How are the wishes, emotions, preferences and values of older persons with cognitive impairment identified, interpreted and respected when communication is difficult, altered or fluctuating?
      1. Examples: communication support, non-verbal expression, involvement of trusted persons, advance expressions of wishes, relational understanding of preferences.
2. Autonomy and participation
   3. In what situations do care, protection or professional practices unintentionally take over decisions or silence the participation of older persons with cognitive impairment?
      1. Examples: overprotection, automatic substitute decision-making, restrictive routines, exclusion from everyday choices or conversations.
   4. How can autonomy be supported in practice when cognition fluctuates, is partial, or changes over time?
      1. Examples: supported decision-making, context-sensitive approaches, fluctuating capacity, shared or relational forms of autonomy.
3. Personhood, relationships and belonging
   5. How does cognitive impairment affect an older person’s role, identity, relationships and sense of belonging in family, community and social life?
      1. Examples: changes in family roles, social withdrawal, loss of responsibilities, stigma, reduced expectations regarding participation.
   6. What stereotypes, fears or social attitudes most often lead to loss of dignity, exclusion or reduced expectations for older persons with cognitive impairment?
      1. Examples: assumptions of incompetence, infantilization, fear of dementia, social avoidance, exclusion from public or cultural life.
4. Good practices and recommendations
   7. What laws, policies, institutions, approaches, practices or enabling environments have helped older persons with cognitive impairment to remain heard, involved, respected and socially connected?
      1. Examples: dementia-inclusive communities, supported communication, person-centred practices, inclusive social environments, participation in ordinary daily life.
   8. What legal, policy, professional or community changes are needed to better protect the autonomy, participation and dignity of older persons with cognitive impairment?
      1. Examples: professional training, legal safeguards, communication practices, anti-stigma initiatives, participation-supporting environments.

How inputs will be used?

We kindly request that your submission be concise and limited to a maximum of 5 pages (or 2,500 words). Submissions can address all or only some of the questions above.

Inputs should be submitted only in English, French, or Spanish.

We appreciate your efforts to submit your valuable inputs for this report, and your collaboration and support for the implementation of this mandate. If there is information that you have previously sent to other special procedures or human rights mechanisms that may be relevant, kindly refer to that information in order to avoid duplication and facilitate coordination.

Deadline for submission: 6 July 2026.

Please email your responses in Word format (subject: “Submission to IE call for inputs – 2026 HRC report”) to hrc-ie-olderpersons@un.org.

Unless specifically requested otherwise and provided they are in line with UN norms and standards, submissions will be posted on the webpage of the mandate at the OHCHR website and may be referenced in the reports. In view of consent and privacy issues, contributions containing names of alleged victims will be considered but not published online.

For additional information on the mandate of the Independent Expert on the enjoyment of all human rights by older persons, please see: https://www.ohchr.org/en/specialprocedures/ie-older-persons.

To contact the mandate of the Independent Expert: hrc-ie-olderpersons@un.org.