France

GPs use a range of validated cognitive screening tools. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most common, but others include the 5-word recall test, Memory Impairment Screen (MIS), Cognitive Complaint Questionnaire (CCQ), and AD8.

Currently, there is no routine screening tool for diagnosing Alzheimer’s disease before symptoms appear. Some hospitals have mobile geriatric teams that perform home-based cognitive assessments at the request of a healthcare professional, particularly for individuals aged 70 and above. These teams assess frailty and memory disorders, collaborate closely with geriatricians, and guide people toward appropriate resources such as memory consultations or day hospitals.

Based on a 2020 report from the French Directorate for Research, Studies, Evaluation and Statistics (DREES), the distribution of standard and advanced imaging equipment varies significantly across the country. The national average for computed tomography (CT) scanners is 3.1 per 200,000 inhabitants, but this density ranges from as low as 0.7 in Mayotte to as high as 5.2 in Hautes-Pyrénées. Similarly, the national average for MRI machines is 2.5 per 200,000 inhabitants, with the availability varying from 0.7 in Mayotte to 4.4 in Paris. While CT and MRI scans are routinely used, PET is strictly regulated by the High Authority of Health and reserved for complex diagnostic situations.

In 2020, there were a total of 143 PET scanners recorded across public, private non-profit, and private for-profit establishments (124 in the former, 19 in the latter). However, unlike for CT and MRI, detailed data on the per-capita distribution of PET scanners by department is not available. The most advanced hybrid TEP-IRM (PET-MRI) machines are much rarer. As of 2021, there were only six such machines in the entire country, located in major university hospital centres in cities including Paris, Lyon, Nantes, and Strasbourg.

In France, genetic testing for Alzheimer’s disease is highly targeted and reserved for suspected cases of autosomal dominant Alzheimer’s disease (ADAD). People meeting the clinical criteria are referred from university hospitals across the country to the Centre National de Référence pour les Malades Alzheimer Jeunes (CNR-MAJ). Apolipoprotein E (APOE) genotyping is not used as a diagnostic test in routine clinical practice in France.

The analysis of CSF, obtained via a lumbar puncture, is the established clinical standard in France for confirming the underlying pathology of Alzheimer’s disease in complex cases. National guidelines position CSF analysis as the first-line biomarker test; a reimbursed Amyloid-PET scan is only considered if a lumbar puncture is contraindicated, unfeasible, or has provided inconclusive results.

Blood-based biomarkers are a promising area of research but are not yet integrated into routine clinical practice or reimbursed by the state. While some commercial blood tests are available, people must pay for them privately at a cost of approximately 150 euros.

France has a dense network of approximately 400 specialised memory clinics, located within hospitals throughout all French territories, supplemented by authorised private specialists. For the most complex cases, such as young-onset or rare dementias, a higher tier of expertise exists in regional Memory, Resource and Research Centres (CMRR), which are often based in university hospitals and also coordinate research and training. France officially has seven Centres of Excellence in Neurodegeneration (Lille, Paris, Montpellier, Bordeaux, Grenoble, Marseille, and Toulouse), all part of the international CoEN network. France also established a national reference centre for young people living with Alzheimer’s disease (CNR-MAJ), defined as those under 60 years of age. It is composed of three specialized memory centres (Lille-Bailleul, Rouen, and Paris-Salpêtrière), each assigned specific missions. The reference Centre for Rare or Early-Onset Dementias is located at the Memory and Alzheimer’s disease Institute at the Pitié-Salpêtrière Hospital (Paris).

Day care centres are available, operating either as standalone facilities or within larger nursing homes (EHPADs). These centres provide therapeutic activities for people living with dementia while offering essential respite for carers. This is complemented by specialised home-based services, most notably the Alzheimer’s Specialised Teams (ESA), which deliver cognitive rehabilitation directly in the person’s home upon a doctor’s prescription. However, there are shortcomings in the training of professionals when it comes to the specific characteristics of Alzheimer’s disease and other forms of dementia.

Palliative care is a legal right in France, although not yet accessible to everyone, and is delivered through a coordinated, multi-setting network. This care is frequently provided within nursing homes, which are increasingly developing a “palliative culture” and often collaborate with mobile palliative care teams for specialist support. For the most clinically complex situations, dedicated hospital-based Palliative Care Units (USP) or Identified Palliative Care Beds (LISP) are available. Palliative Care Networks also exist to coordinate services for people who wish to remain at home.

The French government’s health insurance does not cover the four main medications prescribed specifically for Alzheimer’s disease symptoms. People must pay the full price for these drugs out-of-pocket. The cost has increased significantly since medications have left the price regulation system. This fosters a two-tiered system and even more pronounced inequalities between those who can afford the treatment and those who cannot, even though their specialist prescribes it.

Therapies that are medically prescribed by a doctor are generally well-covered. When Alzheimer’s disease is recognized as a Long-Term Illness (Affection de Longue Durée, ALD), the government’s health insurance covers 100% of the official tariff for therapies like: speech and language therapy, physiotherapy, and cognitive stimulation and rehabilitation. However, even with 100% coverage from the government, several co-payments remain the person’s responsibility. If a therapist charges more than the official government rate, the person is responsible for paying the difference. A deductible of €1 is applied to each paramedical act (like a physiotherapy session), capped at €50 per year (this cap is for all franchises combined, including medication).

The out-of-pocket cost for professional home care or a nursing home in France is directly linked to the patient’s level of dependency, assessed using the Equivalent Resource Group (Groupe Iso-Ressources, GIR) scale. A higher level of dependency (corresponding to a lower GIR number) leads to higher care costs but also entitles the individual to greater financial support. However, access to this support depends on age. For individuals aged 60 and over, the main form of assistance is the Allocation personnalisée d’autonomie (APA). By contrast, people diagnosed with conditions such as Alzheimer’s disease before the age of 60 are classified as disabled adults and may receive the Prestation de compensation du handicap (PCH).

The Daily Allowance for Caregivers (AJPA) compensates individuals who take official caregiver’s leave (Congé de Proche Aidant) from their job. As of 2025, this allowance is set at €65.80 per day and is limited to a total of 66 days for the duration of care for one person. Carers can also be formally paid for their work through two distinct pathways. First, they can become a salaried employee of the person they care for, using funds from the person’s Personalized Autonomy Allowance (APA).50 However, this option is not available to the spouse, civil partner, or cohabiting partner of the person living with dementia. Second, under the Disability Compensation Benefit (Prestation de Compensation du Handicap, PCH) scheme, a carer can receive a direct financial compensation of €7.16 per hour if they have reduced their professional activity, and is available to any family care partner, including a spouse. However, caregivers face many barriers to access support and allowances when needed.

Daily Allowance for Supporting a Person at the End of Life is a separate allowance for those who take Family Solidarity Leave to care for a person at the end of life. The allowance is €64.41 per day for a maximum of 21 days.

Indirect financial relief is available through the tax system. If a carer provides direct financial support to a parent in need, these payments can be deducted from the carer’s taxable income as a pension alimentaire. When the parent lives in the carer’s home, a lump sum of €4,039 can be deducted (in 2024) without needing to provide detailed justification of expenses. Additionally, the ”right to respite” for indispensable carers of APA beneficiaries can provide up to €573.77 per year. This fund is added to the person’s APA plan specifically to finance respite solutions, such as temporary accommodation, that give the carer a break. However, the conditions for accessing this “right” are such that very few caregivers actually have access to it.

When it comes to non-financial aid, Support and Respite Platforms are a single, accessible point of contact for carers of people living with neurodegenerative diseases or other conditions causing a loss of autonomy. Support and respite platforms provide carers and care recipients with information, advice, emotional and practical support, training, and guidance to access services, while also offering respite opportunities and activities that help maintain social connections and reduce isolation. They work locally, in coordination with departmental services, to address both the individual needs of carers and the carer–care recipient pair. This network is geographically extensive. The official national public service directory lists 142 such platforms across the entire country.

The non-governmental sector, led by organisations like France Alzheimer et maladies apparentées also provides crucial non-financial support to carers through free services such as specialized training, psychologist-led peer support groups, and various forms of respite care.

The French Stratégie Nationale Maladies Neurodégénératives 2025-2030 is a comprehensive public health plan designed to address the widespread impact of conditions like Alzheimer’s disease, Parkinson’s disease, and ALS.7, The strategy is structured around six main axes comprising 37 distinct measures:

1. Change Public Perception: Launch national campaigns to inform the public, combat the stigma associated with these diseases, and preserve patient dignity.
2. Prevent and Detect Earlier: Focus on risk prevention and facilitate early diagnosis for better long-term management and care planning.
3. Improve Support for Patients and Caregivers (Aidants): Adapt professional practices, provide greater social and practical support for family caregivers, and integrate stronger ethical considerations into daily care.
4. Transform Home Care: Consolidate and modernise support systems that allow patients to remain safely and comfortably in their own homes for as long as possible.
5. Modernise Care Facilities: Respond to complex medical needs by transforming nursing homes (EHPADs) and expanding specialized environments, such as Adapted Care and Activity Poles (PASA).
6. Support Research and Innovation: Invest in biomedical research, epidemiological surveillance, and therapeutic innovations (including initiatives like the Brain&Mind Biocluster).

This strategy is actively funded, with its financing integrated into broader national and regional healthcare budgets rather than a single, separate fund. Resources from the Social Security Financing Bill, Regional Health Agencies, and national health objectives are allocated toward concrete facility upgrades, home care improvements, and the healthcare “autonomy” branch. Additionally, specific state budget lines are dedicated to supporting vital biomedical research, epidemiological surveillance, and therapeutic innovation. The new strategy was developed in response to the unsatisfactory evaluation of the previous plan and a prolonged period of inaction, including unfulfilled commitments such as the unfunded 2021–2022 national roadmap for neurodegenerative diseases. After the 2022 elections, the Minister of Health reaffirmed the government’s commitment to addressing this major public health issue — now the leading cause of loss of autonomy in France — and tasked stakeholders with developing a new National Strategy. Initially expected in January 2024, the 2025–2030 strategy was ultimately launched in September 2025, due to the political context.

The previous French Neurodegenerative Disease Plan 2014-2019 included multiple neurodegenerative diseases, such as Alzheimer’s disease and related diseases such as Lewy Body dementia, Parkinson’s disease. Its overarching goal was to improve integrated care across hospitals, memory clinics, and community services, emphasising early diagnosis and multidisciplinary management. Support for people living with dementia and families remained central, with measures to expand social and psychological assistance, respite care, and carer training. The plan also sought to strengthen research networks covering multiple neurodegenerative diseases and to promote translational research for faster clinical application. Enhancing information systems and person registries was another key objective, to improve monitoring, data collection, and policy planning. Public awareness campaigns and prevention strategies were included to inform society about neurodegenerative diseases and encourage proactive health measures.

The last Alzheimer’s disease-specific strategy was the Plan Alzheimer 2008–2012. Its primary goal was to improve the care and support provided to people living with Alzheimer’s disease and their families, while also promoting research and public awareness. The plan aimed to enhance early diagnosis, including detection of young-onset cases, and to expand specialized memory clinics (CMRRs) to ensure access to expert care. Supporting people living with dementia and carers was another major priority, through the development of respite care, day centres, home support, and psychological assistance for families. In parallel, the plan sought to promote biomedical and clinical research on Alzheimer’s disease and to create dedicated research networks. Professional training for healthcare and social care workers was emphasized, alongside public campaigns to raise awareness and reduce stigma associated with Alzheimer’s disease. Subsequent plans have bundled Alzheimer’s disease within larger frameworks.

The National Institute of Health and Medical Research (INSERM) collaborates with clinical institutions to conduct biomarker research and testing and has supported over 250 research projects.

Researchers at the Paris Brain Institute and Institute of Memory and Alzheimer’s Disease, located at the Pitié-Salpêtrière Hospital, lead France’s clinical research efforts by managing major cohorts and participating in numerous pharmacological trials for innovative treatments.

The Institut Pasteur is exploring new diagnostic and therapeutic avenues, including the use of llama-derived antibodies to detect brain lesions associated with the disease. Their scientists are also investigating nicotinic receptors as a potential therapeutic target to improve memory function.

Scientists at the Imagine Institute are pioneering a novel approach by investigating the role of mast cells in Alzheimer’s disease pathology, a type of immune cell previously overlooked in this context. This research has led to the co-development of the drug masitinib, which targets neuroinflammation and has shown promise in slowing memory loss in clinical trials.

The Neurodegenerative Diseases Laboratory at the François Jacob Institute of Biology is investigating the specific roles of protein misfolding and reactive astrocytes in disease progression. They are also developing advanced in-vivo magnetic resonance methods to better visualize and understand brain cell interactions.

The Bordeaux Neurocampus, through its Institute of Neurodegenerative Diseases, integrates preclinical and clinical research to investigate the pathophysiology of proteinopathies common to various dementias. The affiliated University Hospital is a site for innovative trials, including a study using a machine-learning model to improve the precision of Deep Brain Stimulation surgery for neurodegenerative conditions.

The Institute for Neurosciences of Montpellier is focused on the specific study of proteinopathies and is a key part of a European Centre of Excellence developing biomarkers for personalized medicine.