WMA Statement on Dementia

Adopted by the 76th WMA General Assembly, Porto, Portugal, October 2025

PREAMBLE

Dementia is a syndrome caused by many different diseases, which collectively form an increasing part of non-communicable conditions globally. According to the World Health Organization (WHO), “Dementia is an umbrella term for several diseases affecting memory, other cognitive abilities and behavior that interfere significantly with a person’s ability to maintain their activities of daily living. Although age is the strongest known risk factor for dementia, it is not a normal part of ageing.”

Dementia is primarily a condition of older people but one in ten affected individuals show signs before the age of 65. As the actual number of older people is increasing steadily around the globe, there is a rising number of cases of dementia. In 2023 the WHO estimated the number of individuals with dementia to be 55 million worldwide and this is expected to rise to 139 million by 2050. Currently, 60% of people with dementia live in low and middle-income countries, but by 2050 this is predicted to rise to 71%.

Dementia incidence and outcome are influenced not only by biological factors but also by social determinants such as education, socioeconomic status, and access to healthcare, which vary widely across regions and populations.

The annual global cost of dementia was estimated in 2019 to be more than 1.3 trillion US$ and is expected to rise to 2.8 trillion US$ by 2030. This figure includes costs attributed to informal care (unpaid care provided by family and other informal caregivers) and direct costs of social and medical care.

Non-communicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for 74% of all deaths worldwide according to the WHO. Dementia is not listed as a major NCD despite its major effects on individuals and families as well as its rising contribution to societal cost. However, dementia risk increases with the five major risk factors on the NCD list of WHO: tobacco use, physical inactivity, harmful use of alcohol, unhealthy diets and air pollution.

Alzheimer´s disease, the most common disease causing dementia, is the seventh most common causes of death globally, but the fourth in high-income countries. Alzheimer´s disease is the only one of the ten most prevalent causes of death with no effective prevention or cure and only limited treatment possibilities.

Women are disproportionately affected by dementia, with greater prevalence rates than men in all age groups and a higher proportion of deaths. Women are also responsible for providing roughly 70% of informal care hours globally, with the highest proportions being in low- and middle-income countries.

Dementia leads to increasing dependency in daily life and decreasing quality of life. As the burden of care increases, the quality of life of the caregiver, typically a close family member decreases as well. Individuals with moderate and severe dementia ultimately need to move to a service or nursing home but in many countries, particularly low- and middle-income countries, this possibility is not available. Nursing home costs are putting an increasing strain on economies, whether inside or outside a national health service.

There is increasing evidence that up to 45% of cases of dementia might be preventable to some extent. This has been supported by the actual decrease in dementia prevalence in the last three decades, but due to the rising number of older individuals, the total number of cases of dementia continues to rise.

Dementia does not generally belong to any one specialty of medicine but is most often the responsibility of either neurology, psychiatry (often senior psychiatry), geriatrics or family medicine. It involves a multidisciplinary approach requiring collaboration across various healthcare fields. However, individuals with dementia are more frequently admitted to hospital than those without dementia independent of physical comorbidities with generally poorer prognosis than non-demented individuals.

Research into treatment options for diseases causing dementia has been lagging compared to other major NCDs and has been mostly futile. New biological treatments for Alzheimer’s disease are very costly and most societies, even the wealthiest, are having difficulties handling the financial burden. In addition, these medications have a limited effects as they are not halting the process of increasing cognitive impairment but only slowing it.

The WHO global actions plan for dementia 2017-2025 states that countries need to develop practical and ambitious national strategies. The plan includes a set of seven global targets such as viewing dementia as a public health priority to improve diagnosis, support for dementia carers and increased funding for research.

RECOMMENDATIONS

The World Medical Association (WMA) calls on the following stakeholders to:

The World Health Organization (WHO) 

1. List dementia as one of the major NCDs globally.
2. Increase its focus on dementia and its causes, particularly in low and middle-income countries since they are expected to face the greatest increase in the number of dementia cases in coming decades.
3. Collaborate with governments, international Alzheimer´s disease bodies as well as the WMA in enhancing global awareness of dementia.

National Governments

4. View dementia as a public health priority.
5. Work along the lines of the WHO global action plan for dementia.
6. Develop comprehensive national dementia strategies including clear targets and measurable indicators, with allocated funding and a clear monitoring and evaluation process.
7. Support risk reduction programs, especially through public health initiatives. Such programs will also help countering other major NCDs.
8. Increase awareness of dementia and support dementia friendly initiatives.
9. Develop programs to support caregivers, including access to respite care, financial support, and mental health services, recognizing their critical role in dementia care.
10. Increase funding for dementia research nationally and through international partnerships with a focus on effective, accessible treatments and care.

Medical Associations and the Scientific Community

11. Promote initiatives to increase physicians´ knowledge about dementia, in order to promote early identification and accurate diagnosis of cognitive impairment, thereby enabling appropriate treatment and care to be provided.
12. Increase awareness that individuals with dementia have special needs when seeking health care for other ailments.
13. Work with other stakeholders to promote high quality care and good quality of life for individuals with dementia.
14. Increase enrollment in clinical trials of appropriate patients with Alzheimer’s disease and related dementias, and their families, to better identify sex-differences in incidence and progression and to advance a treatment and cure of Alzheimer’s disease and related dementias.
15. Encourage studies to determine how best to provide stable funding for the long-term care of patients with Alzheimer’s disease and other dementing disorders.
16. Make available information about community resources to facilitate appropriate and timely referral to supportive caregiver services.