Colombia

Currently Colombia does not have an organised national screening program for the general population; instead, national guidelines emphasise early detection focused on symptomatic individuals within the primary care setting. For clinical assessment, the Montreal Cognitive Assessment (MoCA) has been validated for the local population and is preferred for detecting Mild Cognitive Impairment (MCI), while the Mini-Mental State Examination (MMSE) is largely relegated to staging established dementia due to its lower sensitivity to early-stage deficits. Beyond the MoCA and MMSE, routine assessment in Colombian memory clinics often incorporates functional scales to differentiate between mild cognitive impairment and Alzheimer’s disease.

MRI technology is concentrated in major urban centres, in cities like Bogotá, Medellín, Cali, and Barranquilla. For instance, Fundación Valle del Lili in Cali and Hospital Serena del Mar in Cartagena operate advanced MRI units capable of high-resolution volumetric acquisition. Fluorodeoxyglucose (FDG)-PET is available in major nuclear medicine centres across the country.

Unlike computed tomography (CT) or MRI, Amyloid-PET is often not included in the standard PBS capitation. It usually requires prescription through the MIPRES (Mi Prescripción) platform, a digital tool for requesting technologies not covered by the standard premium. This process requires the specialist to justify the necessity before a medical board, leading to higher denial rates and administrative friction.

Colombia’s approach to genetic testing for Alzheimer’s disease is heavily influenced by the presence of the Paisa Mutation (PSEN1 E280A). This epidemiological feature has created a localised culture of high genetic literacy in regions like Antioquia. However, this does not apply to the general Colombian population; it is specific to families carrying the PSEN1 E280A mutation. The national accessibility for sporadic Alzheimer’s disease testing remains limited and ethically guarded. For the thousands of individuals belonging to the PSEN1 E280A kindreds in Antioquia, testing has historically been facilitated through research grants and the Neuroscience Group of Antioquia. These individuals often have access to genotyping within the context of clinical trials (like the API trials), which also provide genetic counselling — a critical component often missing from commercial testing services.

Traditional CSF analysis for beta-amyloid and tau is offered by private reference laboratories such as Colcan and Synlab, though its use is limited by the invasiveness of lumbar punctures. There is no strong publicly available evidence suggesting widespread access to specialised CSF biomarker testing in public hospitals. The diagnostic landscape is currently shifting with the 2024-2025 introduction of blood-based biomarkers; private laboratories now offer plasma p-tau217 tests, which are increasingly used as a triage tool to rule out Alzheimer’s disease pathology before resorting to more expensive or invasive confirmations.

Access to diagnostic infrastructure is centralised in Colombia’s “Golden Triangle” (Bogotá, Medellín, and Cali), creating a barrier for those in rural or intermediate regions. In Bogotá, high-complexity units like the Centro de Memoria y Cognición Intellectus and the Hospital Infantil Universitario de San José provide integrated care with psychiatry and geriatrics. Medellín stands out globally due to the Grupo de Neurociencias de Antioquia, Sanvicente Fundacion, and the Instituto Neurológico de Colombia, which combine clinical care with advanced genetic research due to the region’s high prevalence of hereditary early-onset Alzheimer’s disease. While intermediate cities like Manizales have established university-led memory clinics and Bucaramanga offers specialised services through institutions like FOSCAL, rural departments often lack permanent neurologists, forcing people to travel to capital cities for basic diagnosis or rely on telemedicine which is limited by connectivity issues. These disparities persist despite the existence of the National Rural Health Plan (Plan Nacional de Salud Rural, PNSR) — a public policy created to guarantee the right to health for populations living in rural and dispersed rural areas. The Plan aims to reduce urban–rural inequities by improving effective access to quality health services, strengthening hospital infrastructure, and promoting a care model adapted to rural communities.

The availability of day and community centres is strictly stratified by socioeconomic status, creating a two-tier system of care. Private centres such as Alzheimer Neuroactivo (present in Medellín, Pereira, and Villavicencio) offer advanced neurocognitive therapies, including Snoezelen multisensory rooms and Wii-therapy, but require out-of-pocket tuition. The state provides “Centros Vida” which are legally mandated by Resolution 055 of 2018 to provide cognitive stimulation. However, although Centros Vida are legally mandated to provide social support and cognitive stimulation for vulnerable older adults (Ley 1276 de 2009; Resolución 055 de 2018), they are not structured as specialised dementia care units.

Palliative care for dementia is legally protected under Law 1733 of 2014 (Ley Consuelo Devis Saavedra), but its practical application is largely confined to home-care models managed by private insurers. There are around 500 palliative care services across Colombia, predominantly at the primary care level (77%). Public institutions offer palliative care services, including state-affiliated entities such as the Instituto Nacional de Cancerología, Hospital El Tunal and the Clínica Rafael Uribe Uribe. There are significant geographic disparities in access, with services heavily concentrated in major urban regions such as Bogotá and the Caribbean, while remote areas like the Amazonia and Orinoquia regions suffer from a critical lack of coverage. Specialised inpatient palliative units are rare and concentrated in high-complexity clinics such as Fundación Valle del Lili in Cali or specialised providers like IPS San Luis in Bucaramanga, which handles people with needs of chronic ventilation.

Alzheimer’s disease care is included within the Health Benefits Plan (Plan de Beneficios en Salud, PBS), which is the mandatory health benefit package in Colombia’s social security health system. This means the government/insurance (EPS) must cover necessary medical care for people living with Alzheimer’s disease that are part of that benefit plan. The PBS covers basic treatments and prescribed medicines that are listed in the PBS. The exact list of medications and technologies is determined by the Ministry of Health and updated periodically.

Standard clinical therapies that are part of recognised medical care for Alzheimer’s disease (e.g., doctor-prescribed rehabilitation, mental health support) fall under the PBS and should be covered by the EPS.

As of late 2025, financial support for care partners of people living with Alzheimer’s disease in Colombia is anchored by Ley 2456 of 2025, which established the National Fund for Protection and Support for People with Disabilities and their Caregivers or Personal Assistants. Recently, the Constitutional Court’s Ruling C-269 of 2025 removed the requirement for carers to be unemployed to access the Special Old Age Pension, allowing families to combine this benefit with other income sources, while Ruling T-293 opened pathways for adult children acting as carers to inherit parental pensions.

Support is also offered through non-governmental organisations (NGOs) and the private sector. The Asociación Colombiana de Alzheimer y Otras Demencias (ACOLADE) and local Alzheimer’s disease foundations (notably in Bogotá, Medellín, Cali, and Bucaramanga) provide carer training, support groups, helplines, cognitive stimulation workshops, and short-term day programs aimed at reducing carer load and improving people’s support. These services are often free or low-cost but do not provide direct financial assistance.

The Neuroscience Group of Antioquia (GNA) and Banner Alzheimer’s Institute have been conducting an Induction and Maintenance prevention trial in members of the world’s largest autosomal dominant Alzheimer’s disease kindred in Colombia. In this study researchers use Donanemab to clear amyloid plaques, followed by the gamma-secretase modulator RG6289 to prevent their regrowth.

Along with the Massachusetts General Hospital, the GNA have been investigating the rare APOE3 Christchurch and Reelin-COLBOS mutations found in resilient individuals to develop new therapies that mimic these natural protective mechanisms against dementia.

Researchers at Universidad del Valle and the ReDLat Consortium are analysing how genetic admixture interacts with social determinants of health, such as education and economic disparities, to create accurate dementia risk models for diverse Latin American populations.