Croatia

Mini‑Mental State Examination (MMSE)
Cognitive assessment in Croatia is based on internationally recognized instruments used throughout Europe. The officially translated Croatian version of the Montreal Cognitive Assessment (MoCA-HR) supports routine screening for cognitive impairment, while more comprehensive assessments such as the Addenbrooke’s Cognitive Examination III (ACE-III) are used in specialist settings. Croatia’s participation in European dementia networks and research initiatives further reflects the alignment of its diagnostic practices with broader European standards for dementia assessment.

Neuroimaging is a key component of dementia diagnosis in Croatia and is routinely used in specialist neurological and psychiatric assessments. Patients with suspected dementia are commonly evaluated in tertiary-care institutions such as University Hospital Centre Zagreb, University Hospital Centre Rijeka, University Hospital Centre Split, and the University Psychiatric Hospital Vrapče. CT and MRI are used to exclude alternative causes of cognitive decline, including cerebrovascular disease, tumours, and other structural abnormalities, while MRI can also identify patterns of brain atrophy associated with Alzheimer’s disease. More advanced imaging techniques, such as FDG-PET and amyloid PET, are available in specialised tertiary centres and are generally reserved for complex or diagnostically uncertain cases.

Genetic testing is not routinely performed for all patients undergoing dementia assessment in Croatia but may be considered in selected cases, particularly when there is an early onset of symptoms, a strong family history of dementia, or suspicion of a hereditary neurodegenerative disorder. Patients requiring genetic evaluation are typically referred to specialist neurology or memory clinics within tertiary-care institutions such as University Hospital Centre Zagreb and the University Psychiatric Hospital Vrapče. Testing may include genes associated with familial Alzheimer’s disease, such as APP, PSEN1, and PSEN2, as well as other hereditary dementia syndromes when clinically indicated. Genetic counselling is generally recommended before and after testing to support patients and their families in understanding the implications of the results.

Biomarker testing is available in Croatia primarily through specialist and tertiary-care centres such as the University Hospital Centre Zagreb and the University Psychiatric Hospital Vrapče. While routine dementia diagnosis relies mainly on clinical assessment, cognitive testing, and neuroimaging, cerebrospinal fluid (CSF) biomarkers, including amyloid-beta (Aβ42), total tau, and phosphorylated tau, may be used in selected cases with diagnostic uncertainty. Advanced techniques such as amyloid PET imaging are also available but are not routinely used in standard dementia assessments.

The cost of dementia care in Croatia varies depending on the type of service and the level of public coverage available through the Croatian Health Insurance Fund (HZZO). Common symptomatic treatments for Alzheimer’s disease, including donepezil, rivastigmine, and memantine, are available as generic medicines and typically cost between $27 and $55 per month. ATTs are not covered like in rest of EU. Specialist consultations are generally covered under the national health insurance system, while day hospital services and certain palliative care services may be fully or partially reimbursed depending on the patient’s eligibility and care setting. For individuals requiring more intensive long-term support, costs can increase substantially. Residential care and specialised dementia units in private nursing homes are typically self-funded, with monthly costs ranging from approximately $1,090 to $1,960. In cases where day hospital, residential, or palliative services are only partially covered, patients and families may face additional expenses that can reach between $655 and $1,310 per month.

Croatia provides financial support for individuals living with dementia and their caregivers through several social welfare benefits. Family care partner may be eligible for the Assistance and Care Allowance, which provides monthly payments ranging from approximately $110 to $195 depending on the level of care required. In addition, individuals living with severe disabilities or advanced stages of Alzheimer’s disease may qualify for the Personal Disability Allowance, a separate benefit that typically ranges from about $160 to $200 per month. These programmes are intended to help offset the costs of daily care and support individuals who require substantial assistance with everyday activities.

People living with dementia in Croatia may access a range of community and residential support services, including home-care assistance programmes and long-term residential care. Informal caregiving remains the cornerstone of dementia support, with most family carers providing assistance on a daily basis and spending a median of approximately 45 hours per week caring for their relative.23 In addition to practical care services, counselling, information, and caregiver support are available through Alzheimer Croatia, which operates awareness programmes, educational activities, and helpline services for people living with dementia and their families.