Russia

Routine clinical assessment for suspected Alzheimer’s disease is conducted using standardised instruments. The Russian version of the Montreal Cognitive Assessment (MoCA-Ru) is a validated and key instrument for clinical use. The MMSE, 5 words test and Addenbrooke’s Cognitive Examination-Revised are also utilised.

Structural neuroimaging (CT and MRI) is widely used in the diagnostic work-up and is generally available in urban hospitals and regional centres. Data from St. Petersburg indicates that the number of medical organizations conducting CT and MRI under the program of state guarantees doubled between 2013 and 2018.

Advanced molecular imaging, such as amyloid and tau PET, has been applied in Russia but its use remains largely confined to research contexts and selected tertiary hospitals in major cities. PET scanning is available also in expert-class institutions and specialised private clinics. Published reports mostly describe isolated clinical cases and small-scale studies, and there is no evidence that these modalities are widely integrated into routine diagnostic practice for Alzheimer’s disease.

Genetic testing for risk factors such as Apolipoprotein E (APOE) genotyping and research-grade polygenic risk panels is available in Russia through university and private laboratories, and several Russian studies have validated polygenic risk approaches in local populations; however, genetic testing is typically used for research, selected clinical cases, or private consumer testing rather than as a routine diagnostic step in everyday clinical practice.

Biomarker testing is an emerging tool for Alzheimer’s disease diagnosis but currently limited to the wider population as an integral part of routine Alzheimer’s disease diagnosis. Cerebrospinal fluid (CSF) assays for amyloid-β and tau are performed in only a handful of specialised research and tertiary centres, so lumbar-puncture-based biomarker diagnosis is not widely accessible across the country.

There is an ongoing exploratory and discovery work on blood biomarkers for Alzheimer’s disease within Russian research groups, indicating the field’s emphasis on assay development and validation rather than wide clinical rollout.

Specialised memory clinics and diagnostic centres for Alzheimer’s disease are heavily concentrated in Moscow and St. Petersburg, where numerous public and private options exist. Major regional capitals like Novosibirsk and Yekaterinburg may have one or two key centres, but such specialised facilities are extremely rare or nonexistent in the rest of the country. To address this gap, the Деменция.net project has established 20 regional prevention centres in cities like Kazan, Omsk, and Murmansk, which offer free primary screening for cognitive changes but do not provide comprehensive long-term medical care.

Day care centres, which provide respite for carers and a stimulating environment for patients, are almost exclusively private and located in the Moscow metropolitan area. In Yekaterinburg, a number of private nursing homes cater to elderly individuals, including those living with dementia and Alzheimer’s disease. In Kazan, the regional Ministry of Labor and Social Protection oversees a network of state homes for the elderly and disabled that accept residents with Alzheimer’s disease.

Palliative care in Russia can be delivered through two main channels: at home via specialised mobile medical teams, or in stationary facilities such as dedicated palliative care departments in hospitals or hospices. The most extensive state-funded provider is the Moscow Multidisciplinary centre for Palliative Care.

In practice, most outpatient medicines are paid out-of-pocket, and many dementia and Alzheimer’s disease treatments are often not routinely provided free to all — prescription patterns studies in Russia report limited use of antidementia drugs and the broader health-system literature documents frequent payments for medicines.

The government does offer a limited subsidy program that only applies to drugs included on the government’s Vital and Essential Drugs list. For Alzheimer’s disease, this list includes Memantine, Rivastigmine, and Galantamine, but excludes Donepezil. To receive any support, one must first be officially assessed and assigned a formal disability status (Group I, II, or III). Depending on the disability classification, a person may be eligible to receive these specific drugs for free or at a 50% discount.

At the federal level Russia has a legal framework for social protection of disabled people and for monthly carer payments that create entitlements to small compensatory payments for individuals who care for people living with disabilities.

The cornerstone of direct state financial support for carers is the monthly compensation payment of 1,200 RUB. This benefit is available to able-bodied, non-working individuals who are providing care for a person living with a Group I disability (a classification that includes many individuals living with advanced dementia), a person over the age of 80, or an elderly person certified by a medical institution as needing constant care.

In larger cities there is a developing market of paid “patronage” and live-in care services and some municipal pilot programmes for day-care, respite, assisted-living models.

Beyond cash allowances, civil-society also plays the role in caregiver support. They run helplines, training, memory café groups, counselling and educational programmes that help families with skills, respite and peer support — but these are typically funded by non-governmental organizations (NGOs), donors or fees and are not a universal substitute for state care packages.

Scientists at St. Petersburg State University are developing molecular tools aimed at detecting amyloidogenic proteins. These tools could potentially be used for earlier and less invasive diagnosis of Alzheimer’s disease.

Several academic institutions, including the Institute of Physiologically Active Compounds at Federal Research centre of Problems of Chemical Physics and Medicinal Chemistry of the Russian Academy of Sciences, the Research centre for Medical Genetics, and the Research Institute of Molecular and Cellular Medicine of the Medical Institute Peoples’ Friendship University of Russia, have been involved in research exploring cell therapy as a potential treatment for Alzheimer’s disease. This includes investigating the use of various stem cells for neuroprotection and regeneration.