As populations continue to age, the number of people living with dementia in OECD countries is expected to rise from an estimated 19 million today to 40.9 million by 2050. Until a cure for dementia is found, this will have large human and financial implications.

Improving the lives of people living with dementia is both a moral necessity and an economic imperative. Too many people with dementia are not diagnosed, and for those who are, a dementia diagnosis can be devastating. Stigma towards dementia remains too common, and many people are left to manage their condition without adequate access to health and social care services that could help them. The cost for individuals and their families is huge – 40-75% of the total dementia care cost. There are high costs for health and care systems from poor quality care, too. Think for example of the large number of hospitalisations of dementia patients that could be avoided through better investment in prevention and care co-ordination. There is growing evidence that prevention to address risk factors for several chronic conditions is also good for preventing dementia. Yet health systems across the OECD only devote less than 3% of health spending to prevention.

In recent years, policy attention towards dementia has grown. At the national level, many OECD countries have focussed efforts on improving the quality of care that people with dementia receive and raising awareness in communities through dementia friends initiatives. Several countries have developed dementia care plans. At the global level, initiatives such as the G8 Summit on Dementia in London (United Kingdom) in 2013 and the creation of the World Dementia Council, among others, are encouraging signs that the global community has taken notice of this pressing issue and is committed to developing innovative solutions to tackle dementia. The OECD has been an active voice in many of these global efforts. The 2015 report Addressing Dementia: The OECD Response already developed a framework for the key objectives of dementia policy.

Yet despite these efforts, we are still failing too many people with dementia. Significant gaps remain in access to and quality of services. Close to 70% of nursing home residents have some form of cognitive impairment, yet staff has often not received training to adequately treat the symptoms of advanced dementia and significant inappropriate use of drugs for behavioural and psychotic symptoms of dementia remains. Data and measurement for dementia are weak and frustrate efforts to monitor progress. Fewer than 40% of countries, for example, are able to estimate their national diagnosis rate.

This report presents an exhaustive look into what OECD countries have done to improve care for dementia across the pathway of the condition. New data collected underscore how far many countries still have to go to ensure that people living with dementia receive high-quality care. In evaluating country progress, this report draws attention to how dementia care continues to be held back by major knowledge and measurement gaps. The findings of this report will help countries further improve how they care for people with dementia today, and set the groundwork for high-quality care in the years to come.