Monaco

The CHPG Memory Centre performs assessment and monitoring of cognitive disorders through a multidisciplinary team. Although its public webpage does not list every cognitive instrument used, clinical assessment would typically involve standardized cognitive and neuropsychological testing alongside functional evaluation and caregiver history. AMPA also promotes early recognition and provides educational information on Alzheimer’s symptoms and diagnosis, reinforcing the clinical pathway by encouraging families to seek assessment earlier rather than interpreting cognitive decline as inevitable ageing.

CHPG has a broad hospital diagnostic infrastructure capable of supporting neurological and geriatric assessment. Structural neuroimaging with CT and MRI is available through the hospital system and can be used to exclude stroke, tumours, hydrocephalus and other structural causes of cognitive impairment. The Memory Centre works with CHPG’s wider technical platform, meaning imaging and other specialist investigations can be coordinated within the same hospital pathway rather than requiring fragmented external referrals. No publicly accessible CHPG source clearly confirms routine domestic amyloid PET or tau PET use, so these should be considered specialist or external investigations rather than standard first-line tests.

Routine genetic testing is not part of ordinary dementia diagnosis in Monaco. Testing for rare inherited Alzheimer’s disease mutations would be relevant primarily in early-onset cases or families with a strong multigenerational history. Because Monaco is closely linked to the French medical system, patients requiring specialized neurogenetic assessment can also be referred to major centres in neighbouring France. No separate Monegasque national genetic-testing programme for dementia was identified.

No public source confirms that CSF amyloid/tau testing or blood-based Alzheimer biomarkers are routinely available to every patient through Monaco’s standard pathway. The Rainier III Centre does, however, combine the Memory Centre with an active clinical research unit, giving Monaco greater capacity than many similarly sized jurisdictions to introduce newer diagnostic methods when clinically or experimentally appropriate.

The Rainier III Clinical Gerontology Centre is the cornerstone of Monaco’s dementia and older-person care system. It has 210 individual rooms and provides the full spectrum of geriatric care, including outpatient consultations, Memory Centre assessment, acute geriatrics, rehabilitation, long-term care, behavioural dementia management and palliative care. Its Memory Centre monitors cognitive disorders through a multidisciplinary team, while the Clinical Research Unit manages trials in geriatric medicine and Alzheimer’s disease. Cognitive Behavioural Unit of the Centre includes a dedicated secure unit for people with orientation problems or behavioural symptoms. It combines geriatric and psychological management within a controlled environment, reducing the need to separate medical and behavioural dementia care.

The Speranza-Albert II Centre is a therapeutic day-care service specifically for adults residing in Monaco who have Alzheimer’s disease or cognitive disorders. Under the 2025 Sovereign Ordinance, the centre must provide an individualized therapeutic and social programme, and treatment is free of charge. This facility allows people to remain at home while receiving structured daytime support and simultaneously provides respite for caregivers.

Monaco Gerontological Coordination Centre acts as a central coordination mechanism for older-person services and links healthcare, home support and social-care providers. It forms part of the wider gerontological network established by the government.

Monaco also operates specialized care homes such as A Qietüdine and Cap Fleuri, which cooperate with the Rainier III Centre and form part of the principality’s integrated gerontology pathway. Residents may receive medical and dependency care, with parts of care costs financed through Monaco’s social security system.

Medical treatment is substantially financed through Monaco’s social security system. Under the state reimbursement framework, approximately 80% of eligible healthcare expenditure is reimbursed, with complementary insurance potentially covering additional costs. Alzheimer’s medicines are specifically reported by AMPA as being reimbursed by the social security funds, substantially reducing direct pharmaceutical expenditure for insured patients. Long-term care costs depend on dependency and facility type. Monaco’s official information on elder-care homes states that care charges are linked to the resident’s dependency level, with the relevant care component covered by Monegasque social security under applicable conditions. The Speranza-Albert II day-care programme is entirely free for eligible Monaco residents, which is particularly important because day care simultaneously supports patients and provides respite for informal caregivers.

Monaco has a relatively developed caregiver-support system. AMPA operates a dedicated Monegasque programme for family caregivers, including an interactive and individualized psychoeducational platform for informal caregivers looking after people with neurodegenerative conditions. It addresses behavioural symptoms, communication and practical caregiving challenges. The Speranza-Albert II Centre also functions indirectly as a respite service because patients can attend structured therapeutic day programmes while continuing to live at home. This gives caregivers periods of relief while maintaining the patient’s cognitive, social and functional engagement. AMPA additionally provides information, public conferences, educational materials, counselling-oriented resources and events specifically addressing the experience of becoming a caregiver for an ageing or cognitively impaired relative. Because Monaco’s gerontology system links the Memory Centre, day care, residential facilities and gerontological coordination, caregivers can be directed toward multiple levels of support rather than navigating the system entirely alone.

Monaco does not appear to have a standalone National Dementia Plan equivalent to those in countries such as France or Czechia. However, dementia is deeply embedded in Monaco’s broader gerontology policy and legislation. Since the early 2000s, the government has built an integrated gerontological pathway centred on the Rainier III Centre, Gerontological Coordination Centre, Speranza-Albert II and specialized residential care. The most significant recent development is Sovereign Ordinance No. 11.517 of 13 October 2025, which formally defined the functions of Speranza-Albert II as a public day-care service for adult Monaco residents with Alzheimer’s disease or cognitive disorders and explicitly made care at the centre free. This means that while Monaco lacks a single strategy document titled “National Dementia Plan,” dementia services have a stronger statutory basis than in many countries that technically possess a strategy but lack implementation.

Current policy development appears focused on strengthening and modernizing the existing gerontological pathway rather than creating a separate national dementia plan. The 2025 legal reform integrated the Speranza-Albert II Centre and Gerontological Coordination Centre more explicitly into the responsibilities of the Direction de l’Action Sanitaire, strengthening formal government oversight and medical coordination. Research and treatment innovation are another priority. CHPG’s Clinical Research Unit actively manages Alzheimer’s and geriatric clinical trials, with the stated objective of giving local patients access to new therapeutic advance. AMPA also continues to emphasize new therapies, neurostimulation, cognition, sleep, non-pharmacological interventions and caregiver support through public and scientific events. Its World Alzheimer’s Day 2025 programme explicitly focused on new Alzheimer treatments and non-drug approaches.itted on 22 January 2026 specifically addressed access to Leqembi in Luxembourg, with the government issuing its response on 19 February 2026.

Integrated Gerontological Pathway: Monaco has deliberately linked the Memory Centre, acute geriatrics, rehabilitation, behavioural dementia care, long-term care, gerontological coordination, residential facilities and day care within one coherent network. This reduces fragmentation between diagnostic and social-care stages and allows patients to move between levels of care as their needs change.

Speranza-Albert II Therapeutic Day Care: This dementia-specific day programme combines cognitive, therapeutic and social interventions while enabling patients to remain at home. Its legal status and free access for Monaco residents make it one of the most clearly institutionalized dementia day-care models among European microstates.
Psychoeducational Caregiver Platform: AMPA operates an individualized interactive programme for non-professional caregivers managing neurodegenerative diseases and behavioural symptoms, expanding caregiver education beyond conventional printed guidance.

Mediterranean Alzheimer Alliance: Launched by AMPA in 2013, the alliance connected associations, healthcare professionals and researchers across 17 Mediterranean countries and promoted shared research, professional education and good practices. It remained active until 2018 and significantly increased Monaco’s international dementia-policy influence.