Singapore

Research conducted in November 2025

Singapore combines advanced technological innovation with a robust community support framework under its National Dementia Strategy. The state is pioneering artificial intelligence (AI)-driven diagnostic tools like Pensieve-AI and has integrated support into the urban environment through the Dementia-Friendly Singapore initiative, which establishes Go-To Points in public hubs for older adults experiencing disorientation. However, this advanced ecosystem coexists with high financial barriers, as new disease-modifying therapies are approved but not subsidised, and strict disability criteria for long-term care insurance often leave families bearing significant out-of-pocket costs.

Overall
AD Rating
Diagnostic Pathway
Singapore uses advanced AI-driven tools like retinal scans to screen patients, though median wait times in public hospitals remain around 4 to 5 months.
Specialized Care
Standard medications are readily available, but high-cost new therapies are currently approved without public subsidies, creating a barrier for some families.
Caregiver Support
The system is tech-forward with apps like CARA, but strict disability criteria for insurance often leave middle-income families with high out-of-pocket care costs.
National Policies
A cohesive strategy integrates support into urban planning through "Dementia-Friendly Communities" and public transit "Go-To Points."
Access to ATT-s
Multiple therapies approved; limited or no reimbursement.
Organizations are listed for informational purposes based on publicly available sources. Inclusion does not necessarily indicate affiliation with or endorsement by Alzheimer’s Disease International (ADI).

Highlights

Health system
Universal, Mixed Funding (Mixed Provision)
ADI member association(s)
Dementia Singapore
National dementia plan
National Dementia Strategy (NDS)
Dementia plan funding
Funded plan
Dementia prevalence rate
764
Dementia incidence rate
135
*per 100k Population
Prevalence Rate (per 100,000): 
This measures the total number of existing cases (both old and new) in a population at a specific point in time, divided by the total population and multiplied by 100,000. It tells you the overall "burden" or how widespread a condition is at that moment.
Incidence Rate (per 100,000): 
This measures the number of new cases that develop in a population over a specific period (usually one year), divided by the population at risk and multiplied by 100,000. This tells you the "speed" or risk of contracting the condition.

Population

5,873,607

Median age

36.2

Health expenditure (% of GDP)

4.9

Diagnosis

Alzheimer’s evaluation in Singapore typically at a GP or polyclinic with interviews and exclusion of other causes, followed by specialist referral for neuropsychological testing, blood work, and neuroimaging. Public patients may wait up to three months for MRI or 35 days for specialist consultations, while private care offers faster access. Cognitive assessment uses CSI-D, CMMSE, ECAQ, and emerging AI tools like Pensieve-AI and ReCOGnAise. MRI and CT scans are widely available, while Amyloid-PET is limited to private hospitals. CSF testing is offered at specialist centres, APOE testing is private, and outpatient costs are subsidised via CHAS or MediFund.

Diagnosis pathway

In Singapore, Alzheimer’s diagnosis usually begins at a GP or polyclinic, involving patient and informant interviews, and exclusion of other causes. Suspected cases are referred to specialists (neurologists or geriatricians) for comprehensive neuropsychological evaluation, blood tests, and neuroimaging. Private care offers faster access to specialists without polyclinic referrals but comes with significantly higher fees.

The diagnosis pathway for Alzheimer’s disease in Singapore typically starts at a primary care level, with a general practitioner (GP) or at a Polyclinic. The initial assessment involves a detailed interview with both the patient and a reliable informant, such as a family member, to understand the nature and impact of the symptoms. To objectively assess cognitive function, the GP uses validated screening tools, and aims to rule out other medical conditions that can cause dementia-like symptoms. If dementia is suspected, the patient is referred to a specialist, such as a neurologist or geriatrician, for a more comprehensive evaluation. This includes in-depth neuropsychological testing to create a detailed profile of cognitive strengths and weaknesses, along with blood tests to exclude other underlying causes. Neuroimaging is crucial for a definitive diagnosis.

In contrast, people who opt for private care, either at a public hospital’s private clinic or a fully private medical centre, face significantly higher costs but gain faster access to specialists without needing a polyclinic referral.

Wait times

Medium wait time (expected)

Wait times in Singapore differ sharply between sectors, with subsidised patients experiencing up to three months for MRI scans and 35 days for specialist referrals, compared to just 12 days for unsubsidised patients in private care.

Waiting times for diagnostic services vary significantly between the public and private healthcare sectors. In 2024, the median waiting time for a new specialist appointment after a referral was 35 days for subsidised patients, compared to just 12 days for unsubsidised patients. For MRI scans, waiting times in the public sector can range from three weeks to three months.

Diagnosis cost

Partially covered

Singapore’s MediShield Life typically excludes outpatient diagnostics, with private plans reimbursing only if followed by hospital admission. CHAS offers tiered subsidies for private GP visits, and public specialist consultations cost S$28–S$78 for subsidised citizens with a referral. MediFund provides emergency financial aid for patients unable to afford care after other resources are exhausted.

National health insurance, MediShield Life, generally does not cover outpatient diagnostic procedures. Private Integrated Shield Plans typically only reimburse these costs if they are linked to a subsequent hospital admission. The Community Health Assist Scheme (CHAS) helps to mitigate the costs of visiting participating private GP clinics. CHAS provides subsidies for medical care, tiered according to household income into Blue, Orange, and Green cards. To access subsidised rates at a public hospital’s specialist outpatient clinic, a referral is mandatory. The cost for a first consultation for a subsidised Singapore Citizen ranges from S$28 to S$78. This figure reflects the general range across Singapore’s public hospitals, not just National University Hospital, though the exact amount varies slightly by hospital and specialist level. For those unable to pay, MediFund serves as a final safety net, but only for subsidised patients after all other financial resources are depleted.

Cognitive tests

Available

Clinicians use a variety of pen-and-paper cognitive tests, such as the Community Screening Instrument for Dementia (CSI-D), Chinese Mini Mental State Examination (CMMSE), and Elderly Cognitive Assessment Questionnaire (ECAQ), which have been validated for Singapore’s multi-ethnic population with adjustments for education level. To improve screening efficiency, Singaporean institutions are developing rapid, AI-powered digital tools. Key examples include Pensieve-AI, a sub-five-minute drawing test from Singapore General Hospital (to be available in 2026), and ReCOGnAise, a 15-minute game-based assessment from a Nanyang Technological University spin-off.

Imaging tests

Commonly used

Both Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans are available across Singapore. Amyloid-Positron Emission Tomography (PET) scans are available at private hospitals for complex cases, however the cost can be high.

Genetic tests

The Ministry of Health Clinical Practice Guidelines on Dementia explicitly state that routine testing of APOE gene is not recommended in dementia diagnosis. However, private specialist genetic testing companies operating in Singapore offer APOE testing either directly to consumers or through clinician referrals.

Biomarker tests

Cerebrospinal fluid (CSF) analysis for Alzheimer’s disease is available at specialist centres, most notably the National Neuroscience Institute. Blood-based biomarkers are not yet in routine clinical use in Singapore for diagnostic purposes, but are used in research context.

Cognitive Tests

Available

Clinicians use a variety of pen-and-paper cognitive tests, such as the Community Screening Instrument for Dementia (CSI-D), Chinese Mini Mental State Examination (CMMSE), and Elderly Cognitive Assessment Questionnaire (ECAQ), which have been validated for Singapore’s multi-ethnic population with adjustments for education level. To improve screening efficiency, Singaporean institutions are developing rapid, AI-powered digital tools. Key examples include Pensieve-AI, a sub-five-minute drawing test from Singapore General Hospital (to be available in 2026), and ReCOGnAise, a 15-minute game-based assessment from a Nanyang Technological University spin-off.

Imaging Tests

Commonly used

Both Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans are available across Singapore. Amyloid-Positron Emission Tomography (PET) scans are available at private hospitals for complex cases, however the cost can be high.

Genetic Tests

The Ministry of Health Clinical Practice Guidelines on Dementia explicitly state that routine testing of APOE gene is not recommended in dementia diagnosis. However, private specialist genetic testing companies operating in Singapore offer APOE testing either directly to consumers or through clinician referrals.

Biomarker Tests

Cerebrospinal fluid (CSF) analysis for Alzheimer’s disease is available at specialist centres, most notably the National Neuroscience Institute. Blood-based biomarkers are not yet in routine clinical use in Singapore for diagnostic purposes, but are used in research context.

Treatment & Care

Dementia care in Singapore is delivered through public memory clinics at hospitals like National University and Tan Tock Seng, specialty centres such as SingHealth Duke-NUS and the National Neuroscience Institute, and private facilities including Mount Elizabeth and Farrer Park. Home-based and residential services are offered by Dementia Singapore and NTUC Health, while palliative care is provided by hospices like Dover Park and Assisi. Families generally cover medication and custodial care costs, though government programs, such as CareShield Life, Home Caregiving Grants, daycare subsidies, and caregiver support initiatives, help offset expenses and provide training, respite, and home modifications.

Specialized facilities and services

Dementia care in Singapore is provided through public memory clinics in hospitals like National University, Changi General, Tan Tock Seng, and specialty centres like SingHealth Duke-NUS and the National Neuroscience Institute, alongside private facilities including Mount Elizabeth and Farrer Park. Home care and residential dementia services are offered by Dementia Singapore and NTUC Health, while palliative and hospice care, through Dover Park, Assisi, and other providers, ensure support for end-of-life needs across multiple care settings.

Memory clinics are primarily located within Singapore’s public restructured hospitals and national specialty centres like the SingHealth Duke-NUS Memory and Cognitive Disorders Centre and National Neuroscience Institute. In hospitals, specialised services are housed within Geriatric Medicine departments or specialised Neurology and Psychiatry clinics. These include hospitals like National University Hospital, Changi General Hospital, Tan Tock Seng Hospital, Singapore General Hospital, Changi General Hospital, Institute of Mental Health, Khoo Teck Puat Hospital, etc. For those seeking care outside the public subsidy framework, several private hospitals also offer dementia diagnostic and treatment services.

Dementia Singapore and NTUC Health offer home-based care options as well as residential nursing homes with dedicated dementia wards, such as Apex Harmony Lodge, Singapore’s first purpose-built residential home exclusively for people living with dementia. For end-of-life needs, palliative and hospice care is available through providers like Dover Park Hospice, which offer inpatient, home and day care services. A network of hospices and hospitals provides palliative care across Singapore like Assisi Hospice, Alexandra Hospital, MWS Home Care & Home Hospice, and many others.

Approved medication

Generic Name Trade Name Used for
Donepezil Aricept, Aricept ODT, Adlarity, Eranz, Memac, Alzepil, Davia, Donecept, Donep, Donepex, Donesyn, Dopezil, Yasnal, Memorit, Pezale, Redumas, Zolpezil, Namzaric* Donepezil is indicated for the symptomatic treatment of mild to moderately severe Alzheimer’s dementia.
Memantine Namenda, Namenda XR, Ebixa, Memary, Axura, Akatinol, Maruxa, Nemdatine, Namzaric* Treatment of adult patients with moderate to severe Alzheimer’s disease.
Rivastigmine Exelon, Exelon Patch, Prometax, Rivastach, Nimvastid Symptomatic treatment of mild to moderately severe Alzheimer’s dementia.
Symptomatic treatment of mild to moderately severe dementia in patients with idiopathic Parkinson’s disease.
Galantamine Razadyne, Razadyne ER, Reminyl, Reminyl XL, Nivalin, Lycoremine, Galsya Galantamine is indicated for the symptomatic treatment of mild to moderately severe dementia of the Alzheimer type.
Lecanemab - approved but not reimbursed Leqembi Lecanemab is indicated for the treatment of mild cognitive impairment and mild dementia due to Alzheimer’s disease in adult patients that are apolipoprotein E ε4 (ApoE ε4) heterozygotes or non-carriers.
Donanemab - approved but not reimbursed Kisunla Donanemab is indicated for the treatment of mild cognitive impairment and mild dementia due to Alzheimer’s disease (AD) in adult patients that are apolipoprotein Eε4 (ApoE ε4) heterozygotes or non-carriers.

*Namzaric = combination of Donepezil and Memantine

Treatment cost

In Singapore, families generally pay out-of-pocket for routine Alzheimer’s medications, with drugs like Donepezil costing around S$200 per month, while monoclonal antibodies such as Lecanemab and Donanemab are not subsidised. MediShield Life does not cover long-term custodial care, and CareShield Life payouts depend on severe functional impairment, excluding many mild-to-moderate cases. Government subsidies partially offset daycare and nursing home fees, primarily aiding low-income households, while middle- and high-income families are largely responsible for covering ongoing care costs.

The routine medications used to manage the symptoms of Alzheimer’s disease are considered an out-of-pocket expense for families. As of 2025, standard symptomatic medications like Donepezil have a recurring monthly cost of about S$200. In contrast, monoclonal antibodies such as Lecanemab and Donanemab, are not currently covered by national subsidies.

The universal scheme, MediShield Life, is not designed to cover the costs of long-term, non-medical custodial care, such as assistance with daily living at home or in a nursing home. Singapore’s national long-term care insurance, CareShield Life, provides monthly cash payouts to help with these costs. However, a diagnosis of Alzheimer’s disease does not automatically qualify a person for these payouts. The key trigger is a functional assessment: the individual must be certified by an accredited assessor as being unable to perform at least three of the six Activities of Daily Living (ADLs), such as washing, dressing, or feeding. This means that during the mild-to-moderate stages of dementia, when a person may require significant supervision and care but can still physically perform most ADLs, they would not be eligible for CareShield Life payouts.

The government does provide significant, means-tested subsidies for care services like dementia daycare and nursing homes. These subsidies can cover a large portion of the fees for lower-income households but are progressively lower for middle- and higher-income families, who are expected to bear a larger share of the cost out-of-pocket.

Caregiver support

Singapore offers multiple financial aids for dementia care, including the Home Caregiving Grant (up to S$600), CareShield Life lifetime payouts, ElderShield term payments, and subsidies for daycare, outpatient care, and domestic help. The Agency for Integrated Care and Dementia Singapore guide caregivers through services, helplines, and respite care, while initiatives such as the Caregivers Training Grant, home modification subsidies, and assistive technology funds support safety, skills development, and access to mobility devices and daily care essentials.

Financial aid from the government includes the Home Caregiving Grant, a monthly cash payout of S$250 or S$400, which will be enhanced to a maximum of S$600 from April 2026. National insurance schemes like CareShield Life and ElderShield provide monthly payouts upon assessment of severe disability; CareShield Life offers lifetime payouts starting from S$600, while ElderShield provides S$300–S$400 for a fixed term. Other support includes means-tested subsidies for services like dementia day care, the Community Health Assist Scheme for outpatient chronic disease management, and a Migrant Domestic Worker levy concession that lowers the monthly fee to S$60.

The Agency for Integrated Care is the central body for navigating financial schemes and service referrals, while Dementia Singapore is the lead specialist agency offering a dedicated Dementia Helpline, caregiver support groups, and specialised respite services like Eldersit. Caregivers can access a S$200 annual subsidy for skills training through the Caregivers Training Grant. For home safety, the Enhancement for Active Seniors programme subsidises up to 95% of the cost for modifications like grab bars and ramps in Housing & Development Board flats, with an expansion to private homes planned for early 2026. The Seniors’ Mobility and Enabling Fund and Assistive Technology Fund help fund assistive devices like wheelchairs and consumables such as adult diapers.

Policy

Singapore’s National Dementia Strategy (2009, updated 2017) promotes early diagnosis, memory clinics, community care, and programs targeting reversible risk factors, while the 2023 Action Plan for Successful Ageing expands preventive health, community support, and senior engagement. Legal frameworks, like the Parliamentary Elections Act, reinforce stigma by broadly disenfranchising those deemed of “unsound mind.” Despite reduced shame among people with dementia, public avoidance has risen, reflecting cultural stigma and uncertainty about how to offer support. The country does not have any upcoming dementia-related strategies.

National dementia plan

Singapore’s National Dementia Strategy (2009, updated 2017) promotes early diagnosis, memory clinics, community care, day-care facilities, and programs targeting reversible risk factors, but full public details are scarce. In 2023, the Action Plan for Successful Ageing introduced initiatives to enhance preventive health, community support, and opportunities for seniors to stay active, socially engaged, and meaningfully involved in society.

Singapore’s National Dementia Strategy (NDS) was established by the Ministry of Health in 2009 and revised in 2017. The plan takes a multifaceted approach that includes nursing homes, community centres, and day-care facilities, along with a community-based programme aimed at identifying reversible risk factors. It also outlines investments in early diagnosis via memory clinics in public hospitals. However, further details remain unknown, as the plan has been adopted but not fully communicated publicly.

In 2023, the government launched the refreshed Action Plan for Successful Ageing, outlining initiatives across Care, Contribution, and Connectedness to help seniors stay healthy, engaged, and socially connected. It was developed through consultations with over 5,000 Singaporeans and introduces new programmes to expand preventive health, strengthen community support, and create more opportunities for older adults to contribute meaningfully.

Upcoming plans

There are no upcoming strategies in Singapore.

Policy gaps

Legal barriers

Legal frameworks in Singapore contribute to stigma by using rigid definitions of mental capacity. The Parliamentary Elections Act broadly disenfranchises those of “unsound mind,” lumping dementia patients with those entirely unfit for citizenship, whereas the Mental Capacity Act allows for partial decision-making. Despite this, the label of incapacity can still diminish autonomy and perpetuate negative social perceptions.

The legislative framework in Singapore often codifies stigma by enforcing binary definitions of competence that marginalise individuals living with dementia. The Parliamentary Elections Act explicitly disqualifies any person found to be of “unsound mind”, a term that lacks clinical precision and groups people living with different types of dementia alongside those unfit for citizenship, symbolically stripping them of their political agency. This contrasts with the functional approach of the Mental Capacity Act, creating a legal dissonance where a person may retain specific decision-making capacities but is blanketly disenfranchised by electoral law.

Unlike the “unsound mind” definition in the Parliamentary Elections Act, Section 5 of the Mental Capacity Act acknowledges that a diagnosis of Alzheimer’s disease does not automatically render a person incapable of all decisions. However, in practice it can still feel stigmatising because being labelled as “lacking capacity” may lead others to treat a person as broadly incapable, reduce their perceived autonomy, and reinforce social attitudes linking capacity loss with mental illness or disability.

Cultural barriers

Surveys show that people with dementia report less shame and loneliness, dropping from 72to 31% between 2019 and 2023, yet public avoidance has jumped from 20% to 72%. While awareness campaigns empower patients, they may increase fear, with many willing to help yet uncertain about the best way to do so.

National surveys reveal that while people living with dementia feel less personal shame and loneliness than in previous years (a drop from 72% in 2019 to 31% in 2023), the general public has become far more likely to avoid them (rising from 20% to 72% in the same period). This suggests that while public awareness campaigns have successfully empowered people living with dementia, they may have inadvertently increased fear and social awkwardness among the public. A large majority of the public expresses a desire to help (almost 80%) but simultaneously feels frustrated by not knowing how (44%).

Research

Singapore’s dementia research spans biomarker studies and digital therapeutics at DRCS, lifestyle and drug trials plus early detection tools at MACC, evidence-based housing design through Dementia-Friendly Singapore, and culturally tailored caregiver support via a mobile app from the Institute of Mental Health, currently in clinical testing.

Clinical trials and registries

Singapore does not have a single, publicly searchable national clinical trial registry specifically for patients. The National Neuroscience Institute coordinates research across multiple hospitals and is the first point of contact for many clinical trials, with an option on their website to apply for current dementia-related studies: https://www.nni.com.sg/research-innovation/clinical-trials

Selected innovative methods

Singapore’s DRCS studies fluid biomarkers (BIOCIS) and digital therapeutics through DEMAND and SHINE to improve cognitive health. MACC leads trials on lifestyle interventions, anti-amyloid drugs such as Lecanemab, and early detection tools like gait and navigation assessments. Dementia-Friendly Singapore applies research to housing design with murals, colour-coding, and walking loops. The Institute of Mental Health develops a culturally relevant caregiver app to support mental health, currently under clinical trial.

Dementia Research Centre Singapore (DRCS) at Nanyang Technological University leads the Biomarkers and Cognition Study, Singapore (BIOCIS), a major study to find fluid biomarker profiles in Asian populations through blood tests, neuroimaging, and retinal scans. Furthermore, DRCS is involved in testing digital therapeutics through studies like DEMAND and SHINE, which use digital platforms to deliver interventions aimed at improving cognitive health.

Memory, Ageing and Cognition Centre (MACC) at the National University of Singapore (NUS) is a hub for clinical trials, leading Singapore’s participation in the SINGER study, which tests if lifestyle changes (diet, exercise, cognitive training) can prevent cognitive decline. It is also a key site for global clinical trials of advanced drugs, including anti-amyloid treatments like Lecanemab and upcoming anti-tau therapies. MACC has also validated advanced blood-based biomarker technology for use in Asian populations and is developing innovative digital tools, like in the SPACE study, to assess subtle changes in gait and navigation as early signs of cognitive decline.

Agency for Integrated Care, Centre for Liveable Cities, and Singapore University of Technology and Design collaborate on translating research into practical changes in the built environment as part of the Dementia-Friendly Singapore initiative. Their joint research on how people living with dementia navigate their surroundings has led to evidence-based design interventions in public housing estates. These include tangible features like large, nostalgic wayfinding murals, colour-coding entire housing blocks for easier identification, and creating safe, easy-to-remember walking loops to improve residents’ independence and safety.

Institute of Mental Health is focused on developing digital support systems for caregivers. Researchers are leading a project to create and test a culturally-relevant mobile app specifically for informal caregivers of people living with dementia. The app is designed to provide mental health support through features like peer support networks, educational resources, and coping strategies, with a clinical trial underway to measure its effectiveness in reducing caregiver depression and anxiety.

Support

Organizations are listed for informational purposes based on publicly available sources. Inclusion does not necessarily indicate affiliation with or endorsement by Alzheimer’s Disease International (ADI).

Dementia-Friendly Singapore builds inclusive communities, provides personalised support and community resources through trained volunteers, Go-To Points, the CARA app for personalised support, and the Voices for Hope self-advocacy programme. Complementing these, DementiaHub.SG offers a government-backed digital portal with personal stories, blogs, e-learning modules, and comprehensive directories of dementia resources and services.

Selected national associations, patient family associations, NGOs:

Dementia Singapore

Selected initiatives

DFSG fosters inclusive communities by training volunteers and businesses and establishing Go-To Points in public spaces like supermarkets and transit hubs to assist individuals who may be lost or confused in public. The CARA app serves as a digital companion, providing people with dementia and caregivers access to personalised support, lifestyle tools, and access to community resources. The Voices for Hope Programme provides a 10-week self-advocacy course, equipping participants with skills to share their stories, influence policy, and challenge societal stigma.

The Dementia-Friendly Singapore
The Dementia-Friendly Singapore (DFSG) movement is a national initiative aimed at building an inclusive society where people living with dementia are understood, respected, and supported. The movement establishes Dementia-Friendly Communities with networks of trained volunteers and businesses. A key feature is the creation of Go-To Points, which are safe return points in public places like supermarkets and transit hubs staffed by employees trained to assist individuals who may be lost or disoriented.
CARA mobile app
CARA mobile app is a digital platform and a mobile application and the world’s first dementia membership programme of its kind. It functions as a lifestyle and community digital platform designed to be a constant companion for persons with dementia and their caregivers, providing easy access to an ecosystem of personalised support, benefits, and community solutions.
Voices for Hope Programme
Voices for Hope Programme is a self-advocacy programme by Dementia Singapore that equips people living with dementia and their caregivers with the skills and confidence to share their stories and perspectives publicly. The 10-week course empowers participants to become active advocates, helping to shape public policy and reduce the stigma associated with the condition by giving a voice to their lived experiences.

Dedicated media outlets

DementiaHub.SG is a government-supported digital platform designed to be the primary entry point for anyone seeking information on dementia. The portal features a rich variety of content, including a blog with personal stories and community voices, practical e-learning courses, and extensive directories of support services.

Understanding the terms

This section explains key terms used throughout the text to help readers better understand the exploration concepts.
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Contents

Understanding the Terms

Terms used throughout this website are explained below.
A

Amyloid-Targeting Therapies (ATT): A class of disease-modifying treatments, primarily monoclonal antibodies, designed to identify and remove amyloid-beta plaques from the brain to slow cognitive and functional decline in early-stage Alzheimer’s. Examples include Lecanemab and Donanemab.

Aphasia: A language disorder that affects a person’s ability to communicate, often seen early in Frontotemporal Dementia.

APOE ε4 Allele: A genetic variant of the Apolipoprotein E gene that is a major risk factor for late-onset Alzheimer’s disease; while not a causative gene, its presence increases the likelihood of developing the condition.

Acetylcholinesterase Inhibitors: A class of medications, including Donepezil, Rivastigmine, and Galantamine, used to treat cognitive symptoms by increasing levels of chemical messengers in the brain.

Advance Directives (DAT): Legal documents, such as Disposizioni Anticipate di Trattamento in Italy, that allow individuals to specify their future medical treatment and care preferences while they still have the capacity to do so.

Alzheimer’s Disease (AD): The most common cause of dementia, characterized by a progressive neurodegenerative decline caused by the accumulation of amyloid plaques and tau tangles in the brain.

Amyloid-beta Plaques: Protein fragments that build up in the spaces between nerve cells, disrupting communication and triggering immune responses.

Amyloid PET Scan: A specialized nuclear imaging test that uses radioactive tracers to visualize and measure the density of amyloid-beta plaques in the living brain.

Atrophy: The wasting away or shrinking of brain tissue, often measured via MRI to support a clinical diagnosis of dementia or Alzheimer’s.

B

Biomarkers: Measurable biological indicators, such as proteins found in blood or cerebrospinal fluid, used to identify the underlying pathology of a disease.

Blood Biomarkers: Emerging, less-invasive diagnostic tests that measure specific proteins like p-tau or neurofilament levels in blood plasma to detect Alzheimer’s pathology.

C

CSF Analysis (Cerebrospinal Fluid): A diagnostic procedure involving a lumbar puncture to measure levels of tau and amyloid-beta proteins in the fluid surrounding the brain and spinal cord.

CT Scan (Computed Tomography): A diagnostic imaging test using X-rays to create detailed cross-sectional images of the brain; used primarily to rule out other causes of cognitive decline such as tumors or strokes.

Clock Drawing Test (CDT): A brief cognitive screening task where a patient is asked to ask to draw a clock face; it evaluates visuospatial and executive function.

Cognitive Screening: The process of using standardized tests to objectively measure an individual’s mental functions, such as memory, orientation, and attention.

Community-based Care: Healthcare and support services provided within the local community, such as daycare centers, home-based nursing, and local support groups, rather than in institutional settings.

Cube Copying Test: A visuospatial assessment task used during neuropsychological evaluations to test a patient’s ability to replicate geometric shapes.

D

Dementia: An umbrella term for a range of neurological conditions characterized by a decline in memory, language, and thinking skills severe enough to interfere with daily life.

Dementia-friendly Society: A community or national environment where citizens and businesses are trained to understand, respect, and support the needs of people living with dementia.

Disease-modifying Therapies (DMTs): A new class of treatments, such as monoclonal antibodies (e.g., Lecanemab), designed to target the underlying biological causes of Alzheimer’s rather than just managing symptoms.

E

Early-Onset Alzheimer’s: A form of the disease that affects people younger than age 65, often linked to the familial genes.

Executive Function: Higher-level mental skills including planning, focusing, and multitasking; these are often what the Clock Drawing Test evaluates.

F

FDG-PET: A type of PET scan that measures glucose metabolism in the brain to identify patterns characteristic of different dementia subtypes.

Familial Alzheimer’s Disease: A rare, genetic form of the disease linked to mutations in specific genes (APP, PSEN1, PSEN2) that typically presents with early-onset symptoms.

Frontotemporal Dementia (FTD): A type of dementia caused by progressive nerve cell loss in the frontal or temporal lobes, leading to significant changes in behavior, personality, and language.

G

General Practitioner (GP): A primary care physician who acts as the first point of contact and gatekeeper for dementia diagnosis, providing initial assessments and referrals to specialists.

Genotyping: The analysis of an individual’s DNA to identify specific genetic variations associated with dementia risk or causation.

H

Hidden Cost: The indirect economic impacts of dementia, such as the loss of income for family members who must reduce working hours or leave their jobs to provide care.

I

Informal Care / Informal Caregiver: Unpaid care provided by family members, spouses, or friends, which represents the vast majority of long-term support for people living with dementia.

J

Japanese Cognitive Function Test (J-Cog): A specialized cognitive assessment tool used to evaluate mental and functional status in specific research or regional contexts.

L

Lewy Body Dementia (LBD): A type of progressive dementia that leads to a decline in thinking, reasoning, and independent function due to abnormal microscopic deposits that damage brain cells.

Long-Term Care Insurance (LTCI): A specialized branch of insurance, found in systems like Germany and Singapore, that provides financial subsidies for daily living assistance and nursing care.

M

Memory Clinic: A specialized, often multidisciplinary center focused on the expert diagnosis, management, and treatment of dementia and cognitive disorders.

Mild Cognitive Impairment (MCI): An intermediate stage between normal aging and dementia where memory or thinking problems are noticeable but don’t yet prevent daily functioning.

Mini-Mental State Examination (MMSE): A 30-point standardized questionnaire used to measure cognitive impairment by testing orientation, recall, and attention.

Montreal Cognitive Assessment (MoCA): A cognitive screening tool designed to be more sensitive than the MMSE, particularly for identifying Mild Cognitive Impairment.

MRI Scan (Magnetic Resonance Imaging): A non-invasive technology using magnetic fields to produce detailed images of brain structure; used to assess brain atrophy and rule out secondary causes.

N

National Dementia Plan: A formal government strategy outlining a coordinated response to manage dementia diagnosis, care, research, and awareness at a national level.

National Health Insurance (NHI): A government-funded or regulated healthcare system providing universal or subsidized medical services to citizens.

Neuroimaging: The use of advanced techniques, such as CT, MRI, and PET, to visualize the structure and function of the brain for diagnostic purposes.

Neuroinflammation: The brain’s immune response to damage or protein buildup; while initially protective, chronic inflammation can accelerate neurodegeneration.

O

Out-of-Pocket Costs: Direct payments made by patients or their families for medical services, tests, or care that are not covered by insurance or public subsidies.

P

Preclinical Alzheimer’s: The stage where brain changes (like amyloid buildup) are present but no outward symptoms are yet visible.

S

Synaptic Loss: The destruction of synapses (the gaps where neurons communicate), which is often the strongest correlate to cognitive decline.

T

Tau Tangles: Twisted fibers of a protein called tau that build up inside nerve cells, destroying the cell’s transport system.

V

Vascular Dementia: The second most common type of dementia, caused by conditions that block or reduce blood flow to the brain, like strokes.