St. Lucia

Although no Saint Lucia-specific dementia screening guideline was identified, cognitive assessment in the Caribbean commonly relies on internationally validated instruments such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), both of which have been widely used and validated in Caribbean and Latin American populations. Consistent with regional practice, clinicians are encouraged to consider educational attainment when interpreting MMSE and MoCA scores to reduce the risk of misclassification.

In Saint Lucia, advanced imaging is concentrated in Castries, where the public Owen King EU Hospital (OKEU) has modern radiology capacity, including an MRI scanner and a newly installed CT service. The private Tapion Hospital also advertises a full radiology suite with MRI and CT, offering an additional on-island option for cross-sectional imaging. Beyond these hospitals, Castries hosts dedicated imaging providers such as GableWoods (GW) Medical Center, which lists MRI and CT among its services, and Rodney Bay’s La Clinic du Corps International, where a 1.5 T MRI was launched in 2023 as part of private-public partnership. Access and affordability still vary by location but together these sites confirm that CT and MRI are available on-island, reducing the need for overseas referrals.

Most of the laboratories list routine services but do not list Alzheimer’s disease-related genetic testing such as apolipoprotein E (APOE) or APP/PSEN1/PSEN2. Instead, private laboratories explicitly note they use referral (send-out) laboratories for specialized tests, with samples shipped abroad. In practice, when Alzheimer’s disease-related genetic testing are pursued, clinicians typically use external providers via send-out pathways, consistent with global guidance that such testing is specialized and usually paired with genetic counseling.

There is no official document that confirms use of cerebrospinal fluid (CSF) Aβ/tau or blood-based Alzheimer’s disease biomarkers in routine clinical practice. The general literature confirms that such biomarkers are clinically validated in more advanced clinics, mainly in the United States, but remain “infrequently used in clinical practice” globally due to access, cost and infrastructure constraints.

Saint Lucia has no publicly documented national network of memory clinics. Instead, most dementia care is routed through hospital neurology or psychiatry services in Castries, mainly at public hospitals like OKEU or private Tapion Hospital. These hospitals offer tertiary services and have demonstrated reliable neurospecialist capacity, serving as a key site for specialist consultations and advanced imaging with MRI and CT. Palliative care capacity is developing but remains mostly focused on patients with terminal conditions such as cancer. Numerous cancer non-governmental organizations (NGOs) and groups like Faces of Cancer Saint Lucia and the Saint Lucia Cancer Society provide navigation and support that can incidentally benefit people living with dementia. However, there is little documentation of dementia-specific palliative pathways, teams, or protocols. At the same time, civil society advocacy still exists through Saint Lucia Alzheimer & Dementia Association (SLADA), but formal, dementia-dedicated clinic networks and palliative standards have not been described in government or PAHO profiles to date.

With UHC still being rolled out in Saint Lucia, many day-to-day dementia-related costs are still largely out-of-pocket or paid through private insurance, while public facilities reduce but do not eliminate expenses. User fees and transport are fully paid out-of-pocket, while medicine in private facilities is also paid out-of-pocket. Higher-ticket items, such as CT and MRI imaging or private home care, tend to fall outside routine public coverage and create the biggest affordability gaps. However, the government’s UHC reform is intended to shift this costs over time by pooling risks across public and private sectors, standardizing benefits, contracting both public and private providers, and introducing clearer payment and referral pathways. Until those benefits are fully defined and funded, comprehensive protection for dementia care is not yet guaranteed.

No dedicated state cash allowances, respite schemes, or carer benefits for dementia are described in public policy documents or Ministry of Health releases. Most of the carer support is handled by NGO sector. For example, SLADA serves as the country’s main advocacy and support organization, offering carer education workshops, peer-support groups, and community awareness campaigns. Its activities focus on reducing stigma, improving early recognition, and empowering families who often serve as the primary carers. Alongside SLADA, other private and NGO actors such as Angels of the West Indies provide dementia-care skills training, home-based assistance, and practical respite for families coping with long-term care needs. These initiatives help fill gaps left by limited formal geriatric or palliative services.

The government of Saint Lucia is advancing two key policy reforms that are highly relevant to dementia care and old adults services. First, PAHO is supporting the Ministry of Health, Wellness and Elderly Affairs in reviewing and updating the national Mental Health Policy and drafting a new Mental Health Bill, with public consultations held in August 2025.Second, the government is engaged in developing a revised National Policy for Older Persons, with consultations underway in 2024-25 to frame an implementation strategy that addresses healthy ageing, integrated healthcare, economic security, and caregiving support. Also, the Ministry of Health, Wellness and Elderly Affairs has launched a “Digital Health Blueprint Toolkit” as part of its ongoing work to build a full-fledged digital health strategy for 2023-2026. The strategy is designed to underpin the country’s broader UHC reforms by using digital infrastructure to improve service delivery, enhance data systems, and reduce access and efficiency gaps.
Together, these reforms could enable future dementia-specific strategies by embedding older-person and mental-health priorities, such as screening, long-term care, carer support and rights-based legislation, into law and practice.

Country-specific innovations in Alzheimer’s disease diagnostics or therapeutics have not yet been documented in Saint Lucia, which reflects limited research infrastructure and small-scale neurology services. However, several system-level innovations are beginning to take shape through broader health-sector reforms that could indirectly strengthen dementia care. The UHC reform, supported by the World Bank and PAHO, aims to expand financial protection, integrate public and private providers, and reduce out-of-pocket spending on specialist consultations, imaging, and chronic-disease medications. At the same time, Saint Lucia’s National Digital Health Strategy (2023–2026) envisions electronic health records, telehealth services, and e-referral platforms linking primary care with hospitals like OKEU and Tapion. When fully implemented, these systems could improve continuity of care, enable remote specialist consultations for neurological conditions, and support routine medication monitoring for people living with cognitive impairment. Over time, the convergence of UHC financing and digital integration could create the operational backbone for more structured dementia pathways facilitating earlier detection, coordinated follow-up, and better access to essential medicines.