Macau SAR

Macao’s primary-care network uses brief screening tools like MMSE and MoCA to detect memory or functional “red flags,” triggering referrals to hospital-level assessments. Comprehensive testing occurs at the Memory/Dementia Medical Center or private hospitals, with early detection reliant on GP judgment and patient initiative.

Macao offers CT and MRI widely, while PET/CT, used for atypical cases or biomarker-supported diagnoses, is mainly private and often patient-funded unless publicly justified.

Genetic testing is not part of Macao’s public dementia pathway; families seeking APOE or early-onset testing typically pursue private, cross-border services.

CSF and blood-based biomarkers in Macao are rarely available, typically limited to tertiary centers or regional collaboration.

Macao operates a relatively compact but multi-layered dementia-service ecosystem built around its public health network. At the core is the primary-care referral structure, which anchors memory services within government facilities and ensures that diagnostic workups, follow-up consultations, and case management can be coordinated through the Memory/Dementia Medical Center at the public CHCSJ or private hospitals such as, Kiang Wu Hospital. The government also established a Dementia Support Center, which functions as a community hub for post-diagnosis assistance offering cognitive stimulation sessions, psychoeducation, behavioural-management guidance, and limited respite-like programming.

Parallel to this public backbone, several non-governmental organizations (NGOs) expand capacity and reach. The Macao Alzheimer’s Disease Association (MADA) conducts community screening days, carer workshops, and public-awareness campaigns. Caritas Macao runs day-care and social-service programmes that include dementia-friendly engagement, while Kiang Wu Nursing College provides outreach and training initiatives that strengthen professional and community competencies. Together, these organizations contribute day-care services, carer support groups, counselling, and dementia-friendly community activities.

The Ten-Year Action Plan for Elderly Services (2016–2025) and the 2016 Dementia Policy jointly expanded service capacity, particularly through formalizing referral networks and creating the Dementia Support Center. Nevertheless, policy reviews continue to highlight shortages, especially in the supply of dementia day-care places and the long waiting times for residential long-term care, which remain a major pressure point as the population ages. Palliative care is available in hospital settings, but dementia-specific palliative pathways, including anticipatory care planning, behavioural symptom management, and carer support at end-of-life, are still maturing.

The public system in Macao maintains a strong subsidy framework: specialist consultations at CHCSJ and most dementia-related medications are offered at reduced cost for residents, subject to formulary rules, eligibility criteria, and staged dispensing policies. This means that the majority of standard Alzheimer’s disease drugs, when prescribed through the public pathway, are available at low out-of-pocket cost. However, if a medication is non-formulary, temporarily unavailable, or if a family opts to obtain it privately (including brand-name products), the cost becomes fully out-of-pocket. Private hospitals and clinics operate on a self-pay model, where consultation fees, imaging, pharmacotherapy, and optional services (e.g., genetic testing, private PET-CT) can be substantially higher. Families who prefer private continuity-of-care or faster access generally absorb these costs. Overall, the public model reduces financial barriers for typical cases, while the private sector offers speed and convenience at higher expense.

Carer support in Macao is delivered through a mix of government and NGO partnerships, reflecting the policy emphasis on community-based care and dementia-friendly environments. Initiatives are anchored by the Dementia Support Center, which offers structured cognitive stimulation sessions, psycho education, carer training, and respite-like activities that help reduce carer load. NGOs such as MADA and Caritas run helplines, workshops, support groups, and dementia-awareness campaigns that encourage early help-seeking and equip families with practical skills for behavioural management and daily care.
These programs also support community engagement through dementia-friendly neighbourhood activities, volunteer mobilization, and public education events. While Macao provides general cash allowances for older residents and low-income families, these are not dementia-specific carer subsidies, meaning financial relief for families caring for people living with severe impairment is limited. Policy reviews emphasize the importance of expanding structured respite, day-care provision, and behavioural-support services to better serve the growing dementia population.
Although the government introduced a Caregiver Subsidy Pilot Scheme in 2020-2021, it applied only to care partners of people living with severe intellectual disabilities or those who are permanently bedridden, excluding most carers of people living with dementia. As a result, support remains fragmented and financially inadequate, increasing the load on families and potentially affecting the well-being of both carers and people living with dementia.

Macao’s dementia governance is anchored in the Macao Dementia Policy (2016), released as a dedicated pillar within the broader Ten-Year Action Plan for Elderly Services (2016–2025). The plan integrated dementia objectives across short-, mid-, and long-term phases and focused on improving medical and social care infrastructure. Key priorities included strengthening cognitive assessment and specialist services, expanding memory clinics and long-term care, enhancing public education and prevention efforts, building professional capacity, and establishing tracking and registry systems. Overall, the Ten-Year Action Plan is structured around four pillars, medical services, rights protection, social participation, and living environment, encompassing 445 measures aimed at creating an inclusive society where older adults are supported, valued, and able to participate actively. Within this framework, dementia care is positioned as a central component of broader ageing policy reform.
This policy formalized a territory-wide framework for optimizing of services, and service configurations, public education, capacity building of care providers and a tracking and registry system. Under this framework, all primary health centres operate cognitive assessment networks, ensuring that front-line clinicians can identify early cognitive decline and trigger standardized referrals to higher-level services. At the hospital level, the creation of the Dementia Medical Center at CHCSJ consolidated diagnostic expertise, imaging capacity, and case management, while the Dementia Support Center expanded community-based follow-up, caregiver education, cognitive-stimulation programmes, and psychosocial support. By 2021, this integrated model was recognized internationally as Alzheimer’s Disease International (ADI) classified Macao as a “Stage 5A – Advanced Implementation” role model, noting its rare combination of formalized policy, operational services, and measurable system strengthening.

According to the 2025 Macao Yearbook, the territory reported substantial progress in implementing system reforms, such as 85 of the 100 long-term measures under the Plan for the Elderly Services (2021–2025) were completed by 2024. The next planning cycle will prioritize continuity, strengthening the integration of medical and social care, embedding dementia-friendly design principles into community planning, expanding capacity for cognitive assessment and early detection, and scaling NGO-government collaborations. Forward-looking elements also emphasize improved long-term care infrastructure, expansion of dementia-friendly transport and community environments, and development of professional training pathways to meet demographic pressures. Collectively, these priorities set the stage for a post-2025 dementia policy architecture, likely to build on the existing referral networks while enhancing biomarker availability, multi-sector coordination, and community-based support.

Macao’s combined government-NGO architecture has developed a one-stop integrated dementia model, linking screening, diagnostic confirmation, and post-diagnostic support under a unified pathway. Primary care centres conduct systematic cognitive assessments, CHCSJ provides diagnostic workups and case management and the Dementia Support Center delivers cognitive stimulation, psycho-education, psychosocial support, and signposting. This coordinated model reduces fragmentation and ensures smoother transitions across care settings.

A key contributor to community innovation is the Kiang Wu Nursing College (KWNC), whose programme “Benevolence Lights Up My Later Life” expands training for caregivers, nursing students, and community volunteers. It also provides hotlines, psychosocial counselling, and community cognitive-support services. Evaluations highlight its role in strengthening professional competencies and widening public access to dementia-friendly practices, especially important in a territory with rapidly ageing demographics.