Switzerland

Mini-Mental-Status-Examination (MMSE) and Clock Drawing Test (CDT) are the most commonly used cognitive screening tests in Switzerland. Other tests, like the Montreal Cognitive Assessment (MoCA) are available and used as well.

Switzerland does not have a national screening programme for the general population for Alzheimer’s disease.

Structural neuroimaging with Magnetic Resonance Imaging (MRI) and Computed Tomography (CT), as well as Positron Emission Tomography (PET) scanners are available across Switzerland.

In 2021, The Swiss Society of Nuclear Medicine and the Swiss Memory Clinics have jointly published Appropriate Use Criteria for amyloid-PET. These criteria specify that amyloid-PET is most useful for people living with persistent, progressive, and unexplained Mild Cognitive Impairment (MCI), or for individuals who meet the criteria for possible Alzheimer’s disease diagnosis but present with an atypical clinical course or suspected mixed etiology. Also, the introduction of subsidised FDG-PET within Medicare (the publicly funded universal healthcare system in Australia) means the use of FTG-PET is a more common element of diagnostics.

Testing for Early-Onset Familial Alzheimer’s disease genes (example-APP, PSEN1, PSEN2) is governed by the Swiss Federal Act on Human Genetic Testing, which mandates that such tests be ordered by a physician and be accompanied by comprehensive pre- and post-test genetic counseling. This ensures that patients provide informed consent and receive the necessary support to understand and cope with the results.

Analysis of biomarkers in cerebrospinal fluid (CSF) is an established and accessible diagnostic method in specialised Swiss Memory Clinics (both private and public).

Specialised memory clinics for Alzheimer’s disease are primarily located in cities with university hospitals, including Basel, Bern, Geneva, Lausanne, and Zurich. While urban residents have good access to high-quality diagnostics, those in rural cantons may face significant travel and potential delays in receiving a comprehensive assessment. For example, Zurich alone hosts 11 memory clinics. In contrast, smaller or less densely populated cantons, like Uri or Graubünden, typically have one or two clinics, often linked to a local hospital. Some alpine or rural cantons (e.g., Schwyz) require residents to travel to neighboring cantons for specialist care.

At-home support is available throughout the country via the subsidised Spitex network for nursing care and private agencies for non-medical help. Day care centres, which offer caregiver respite, are also available, such as the Pilatusblick centre near Lucerne that provides small-group, home-like care. For residential care, options range from traditional nursing homes, many with dedicated dementia wards, to highly specialised, purpose-built centres found in cities like Zurich. Switzerland also hosts a dementia village in Wiedlisbach, designed to fulfill needs of people living with dementia.

Palliative care is available and is guided by the National Guidelines on Palliative Care. Specialised inpatient palliative units offering short-term, acute symptom management are unevenly distributed, and are mostly located within major hospitals in urban centres like Zurich and Geneva. The Geneva Palliative Care Network serves as an exemplary model, coordinating a full range of services from mobile medical teams to social and spiritual support throughout the canton. The existence of such integrated networks is highly dependent on cantonal policy, meaning access to holistic, continuous palliative support varies significantly based on a person’s place of residence.

Approved anti-dementia medications are covered by the mandatory basic health insurance provided by the government and private nonprofit insurers. Treatments that are explicitly prescribed by a doctor for a recognised medical purpose, such as physiotherapy, are also covered by mandatory basic health insurance, as well as up to 50% of medically necessary transport, capped at CHF 500 per calendar year.

Many beneficial non-drug treatments—such as music therapy, art therapy, and certain forms of specialised psychotherapy—are generally not covered by mandatory basic health insurance. Alzheimer Switzerland is actively campaigning for this to change, as many patients currently cannot access these therapies unless they pay for them privately. Some voluntary supplementary insurance policies may offer partial coverage for these types of therapies, but it depends on the specific plan.

For daily living assistance, patients can apply for a Helplessness Allowance, a non-means-tested cash benefit based on their level of dependency, which can be used to pay for private support. If a patient’s income and assets are insufficient to cover the high costs of care, particularly in a nursing home, they have a legal right to Supplementary Benefits (Ergänzungsleistungen), a means-tested programme that bridges the financial gap. Additionally, for those diagnosed before retirement age, Disability Insurance may provide a pension and cover costs for necessary aids or home modifications. The full list of financial benefits people living with Alzheimer’s disease or other dementia can access can be found on this link: https://www.alzheimer-schweiz.ch/de/ueber-demenz/beitrag/demenzbetroffene-haben-anspruch-auf-finanzielle-unterstuetzung

Care Credits programme is a non-monetary benefit where a “fictitious income” is credited to the caregiver’s personal state pension account for each year they provide care, protecting their long-term financial security by compensating for career interruptions.

Caregiver Employment Model also directly empowers caregivers by transforming their role into a formal, salaried profession through Spitex agencies, which includes professional training, paid leave, and integration into a specialist support team.

Alzheimer Switzerland organises specialised Alzheimer Holidays that allow both the caregiver and the person living with dementia to take a supported vacation. Alzheimer Switzerland and Pro Senectute serve as points of contact, offering expert counseling, training courses, and local support groups where caregivers can share experiences. The latter also provides digital tools like the iSupport Swiss app to enhance caregiver skills.

National Dementia Strategy (2014–2019) was approved jointly by the federal government and the cantons and it revolved around four main fields of action, each underpinned by specific objectives aimed at improving dementia care and support:

1. Health Literacy, Information & Participation: the goal was to raise public awareness and understanding of dementia and to empower individuals living with dementia and their families to participate actively
2. Needs-Based Services: to provide tailored, integrated support, from early detection and diagnosis to ongoing care, and to promote flexible medico-social offerings attuned to patient needs
3. Quality of Care & Professional Competence: to improve care standards through training and upskilling for healthcare professionals, and to encourage certification and ensure consistent quality across services
4. Data & Knowledge Transfer: to strengthen the exchange of research, best practices, and reliable data, and to enhance planning and policy-making through informed insights

Following the completion of the National Dementia Strategy, the federal government and cantons launched the National Dementia Platform, with a goal to ensure all individuals living with dementia and their caregivers receive care, support, and treatment tailored to their needs. The platform brings together 88 member organisations, encompassing all Swiss cantons as well as national bodies like Alzheimer Switzerland.

Researchers at University Hospitals of Geneva are involved in various projects, including the AMYPAD project, which focuses on improving the understanding of beta-amyloid proteins as diagnostic and therapeutic markers using PET imaging, and the PRETAD project, which examines the ethical, clinical, linguistic, and legal aspects of predictive testing for Alzheimer’s disease.

A team of researchers at the University of Fribourg has pioneered the investigation of saliva-based biomarkers for the early diagnosis of Alzheimer’s disease. Their research has shown that analysing the microbial flora in saliva can help identify individuals at risk even before the onset of visible symptoms.

A collaborative group from the University of Geneva, Geneva University Hospital, and Italian partners have published a European consensus diagnostic pathway in Lancet Neurology. This tool enables memory clinics to deliver individualised diagnostic strategies, mapping 11 clinical phenotypes and aligning the most appropriate biomarker tests (e.g., lumbar puncture, amyloid/tau PET), thus improving accuracy, reducing unnecessary tests, and preparing for precise therapeutic interventions. The HUG Memory Clinic at the Geneva University Hospitals is a key centre conducting research that directly compares the performance of new blood tests against the established gold standards of CSF analysis and PET imaging.