Dementia is a major global challenge of population ageing. It covers brain disorders including Alzheimer’s disease, which progressively damages and kills brain cells, causing a gradual deterioration of a person’s functional capacity and social relations. To date, there is no cure and disease‑modifying treatments only slow progression of the condition at the risk of side‑effects.
As countries age, the number of people living with dementia is also expected to increase. Across 19 OECD countries, 61 people per 1 000 population aged 65 and over were estimated to be living with dementia in 2023 (Figure 10.7), ranging from 24 per 1 000 population in Colombia to 122 per 1 000 in Japan – although differences in diagnostic rates, definitions and measurements hamper international comparability.
At least 24 of 29 OECD countries have stand-alone dementia plans aimed at improving the prevention, diagnosis and care delivered to people with dementia (OECD, forthcoming[1]). Dementia prevention remains a challenging area, although around 45% of dementia cases on the globe are subject to modifiable risk factors, such as chronic disease management (Livingston et al., 2024[2]). Early intervention can delay dementia’s progression but requires early diagnosis. At least 23 OECD countries have diagnostic guidelines to support healthcare workers in recognising symptoms and in streamlining diagnostic pathways.
Recent progress in pharmaceutical research and development has raised new hope in dementia treatment. While these new medications aim at slowing down the progression of Alzheimer’s disease, their non-negligible side‑effects, unfavourable cost-effectiveness, limited clinical practices and significant administrative burden limit access to the drugs, leading countries to exercise caution in adopting them into healthcare systems. As of July 2025, donanemab (Kisunla) has been approved in Australia, Japan, Mexico, the United Kingdom and the United States, and lecanemab (Leqembi) has been approved in the European Union, Israel, Japan, Korea, the United Kingdom and the United States, with reimbursement status varying by country.
In treating mild to moderate dementia, multidimensional lifestyle interventions (such as the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)), and non-pharmacological approaches (such as physical and music therapy) have shown promising results. However, the level of implementation differs across countries.
As the illness advances, many people with dementia experience behavioural and psychological symptoms. Non-cognitive symptoms should be managed with non-pharmacological methods first; short-term antipsychotics are recommended only when these fail and the risks of non-treatment outweigh potential harms.
However, inappropriate use of these drugs remains widespread, and reducing their overuse is a policy priority. Across 17 OECD countries, an average of 54 per 1 000 people aged 65 and over were prescribed antipsychotic medicines. In 2023, antipsychotic prescribing varied by a factor of almost six across these OECD countries, from just 16 prescriptions per 1 000 people aged 65 and over in Sweden to more than 90 prescriptions per 1 000 in Slovenia. Moreover, age‑standardised rates of antipsychotic prescribing were 27% higher for women than for men across the 17 OECD countries (Figure 10.8).
