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Purpose: This study is aimed at the case of the cognitive health design pilot projects promoted by the Seoul Metropolitan Government since 2014 in terms of design to solve social problems in accordance with the aging population of our society. The purpose of this study is to analyze the maintenance and management of the projects and to suggest implications for the promotion and expansion of sustainable cognitive health design in the future. Method: It set the analysis frame by dividing management into maintenance-damage-demolition for the spatial types and spatial elements suggested in the Seoul Cognitive Health Guidelines. And it analyze the actual conditions of four pilot projects based on the field survey. Results: First, the ratio of damage and demolition was higher than maintenance. Second, designs and techniques with low durability were applied. Most of the cases where floor marks were applied to the external environment were lost or difficult to recognize, and their functions were limited due to storage of goods and parking of vehicles and motorcycles. Third, there was a large variation according to the type of residence. The project contents that can be applied to the low-rise residential area were also limited, and more elements were demolished than in the apartment type. Implications: First, it should limit project contents of space types and space elements that can be maintained even over time. Second, it should seek sustainable design and technical solutions. Third, it should seek alternatives to cognitive health design in low-rise residential areas where a large number of elderly people live.