Honduras

There is no documented nationwide dementia screening program. Case finding is therefore symptom-driven, initiated through clinical presentation in primary care or during specialist consultation rather than through systematic early detection. Cognitive assessment is clinically determined and variable, forming part of routine work-up in specialist or hospital settings rather than a protocolized national pathway. While no standardised national test battery is mandated, widely used instruments such as the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) are available in Spanish, as across much of Central America, and are used in practice according to clinician preference and setting.

Structural neuroimaging, computed tomography (CT) and magnetic resonance imagining (MRI), is typically part of the dementia differential diagnosis, particularly to exclude secondary or reversible causes. In Honduras, this capacity is concentrated in tertiary and larger regional hospitals, primarily in major urban centers, and access is strongly shaped by the payment route. In the public sector CT or MRI is available in referral hospitals but may involve delays, limited slots, or equipment constraints, while private imaging centers offer faster access at substantially higher cost. Positron emission tomography (PET) imaging (including FDG-PET or amyloid PET) is not part of routine clinical care and is not documented as available for dementia work-up within the public system; where obtained, it is typically accessed privately or off-island for selected cases, rather than as standard practice.

There is no evidence that genetic testing for Alzheimer’s disease, such as apolipoprotein E (APOE) genotyping or familial dementia panels, is incorporated into routine public diagnostic pathways. Where genetic testing is pursued, it appears to be exceptional and case-specific, most often accessed through private providers or referral abroad, rather than embedded in standard clinical care.

Similarly, Alzheimer’s disease biomarkers, including cerebrospinal fluid (CSF) markers (Aβ, total tau, phosphorylated tau) and emerging blood-based biomarkers, are not part of routine diagnostic practice in Honduras. Any use is more plausibly limited to selected specialist or research contexts, or obtained through private care or evaluation abroad, rather than systematically available within the public health system.

Honduras does not have a clearly documented national network of memory clinics or dementia-specific specialist centers. Dementia care is delivered through a range of health, social, and community organisations, but services remain fragmented and coordination between providers is limited. Organisations often have diverse connections and collaborate on an ad hoc basis, yet many are unaware of other relevant providers with whom they could coordinate, creating gaps in referrals, information sharing, and continuity of care. Specialist capacity is geographically concentrated in larger urban centers, particularly Tegucigalpa and San Pedro Sula, limiting access for rural populations. Multidisciplinary dementia teams, consisting of neurologists, geriatricians, psychologists and social workers, are not systematically established within the public sector, and care coordination often depends on family initiative and private referral. In this context, civil society actors, most notably the ASHALZ, play an important navigation and support role, complementing limited formal service infrastructure.

The older population is generally facing treatment cost challenges as 42% do not receive regular healthcare, 64% have no monthly income, and only 7% receive a social pension. Treatment costs represent a major barrier to sustained dementia care, with out-of-pocket spending accounting for roughly half of total health expenditure. Families, therefore, frequently bear the costs of follow-up consultations, medicines, diagnostic monitoring, and supportive therapies, especially when relying on private providers to obtain timely care. Over the course of a progressive condition such as dementia, these expenses accumulate, influencing whether treatment is initiated early, maintained consistently, or discontinued altogether. Financial exposure therefore affects not only access but also treatment adherence and quality of care, reinforcing socioeconomic and geographic inequities.

Carer support is predominantly non-governmental organisation (NGO)-linked rather than systematized within public services. The ASHALZ provides education, awareness raising, carer guidance, and signposting, serving as a key support pillar in a context where formal long-term care and respite services are limited. At the regional level, the Pan American Health Organization promotes carer skills training, most notably through World Health Organization (WHO) and Pan-American Health Organization (PAHO) iSupport resources, which can help bridge gaps in formal service provision, though uptake depends on local dissemination and capacity. Overall, carer challenges remain high, with families acting as the primary care providers for people living with dementia.

For example, The ASHALZ is supporting the creation of Honduras’ first Adult Day Care Center for people living with dementia, addressing a major gap in services for affected individuals and their families. The center will provide a safe environment, nutritious meals, social and cognitive stimulation, physical exercise, and individualized therapies, offering structured daytime care while enabling family caregivers to work and manage daily responsibilities. With services offered on a sliding scale fee structure to support low-income families, the initiative aims to improve quality of life and relieve carer challenges, with an initial impact expected for around 20 families, marking a significant step in dementia care infrastructure in Honduras.

In the Honduran context, innovation in dementia care is service delivery and system integration oriented rather than biomedical. The most realistic lever for improvement lies in embedding dementia into primary health care strengthening and integrated service networks, in line with PAHO-supported reforms aimed at universal health coverage (UHC). This includes task-shifting to primary care, improving recognition and referral of cognitive impairment, integrating carer support into community services, and using existing chronic-care platforms to manage dementia as a long-term condition. Such approaches offer scalable gains without requiring high-cost specialist infrastructure.

In July 2024, Honduras advanced its health sector digital transformation through the implementation of the Perinatal Information System Plus (SIP Plus), led by the Ministry of Health (SESAL) with technical support from PAHO/WHO Honduras and the Latin American Center for Perinatology. Integrated within the country’s Electronic Health Record framework and grounded in Primary Health Care and Integrated Health Services Networks, SIP Plus enables standardized, real-time collection and analysis of health data, automated reporting of demographic and disease indicators, and improved decision-making. The integration of birth registration data, achieved in partnership with the National Registry of Persons and the National Institute of Statistics, marks a significant milestone in health information governance.

While SIP Plus is focused on maternal, neonatal, and reproductive health, its rollout is relevant to future dementia and Alzheimer’s disease care as evidence of Honduras’ capacity to deploy interoperable, data-driven health information systems at scale. This infrastructure provides a foundation that could be extended to support chronic and neurocognitive conditions, including standardised referral pathways, longitudinal patient tracking, and population-level surveillance, critical enablers for improving dementia care in a resource-constrained system.

A recent analysis of modifiable dementia risk factors in Latin America found that, in Honduras, the highest population attributable fractions (PAFs) for dementia were associated with lower educational attainment, smoking, and depression, suggesting that prevention efforts targeting these factors could have a substantial impact on reducing future dementia challenges.