Perspective on strengthening dementia prevention and control system: a comprehensive framework for national health

China’s rapidly ageing society—487 million people ≥ 60 years by 2050—faces an escalating dementia crisis: 15 million patients already account for one-quarter of the global total, while combined dementia and mild cognitive impairment affect 54 million citizens. Deaths from Alzheimer’s disease have risen 140% in two decades, making it a top-six cause of mortality, and annual care costs are projected to surge from US $168 billion in 2015 to US $1.9 trillion by 2050. Care-giver burden is equally stark: 84 % report sleep disturbance and 44% anxiety, while 77% of patients depend solely on unpaid family support. Current prevention and control systems, however, remain fragmented and under-resourced. Diagnosis is missed in 86% of community cases—well above the global 75%—and only 660 memory clinics operate nationwide against a need for > 3 500. Drug development lags behind the West; beyond the controversial anti-amyloid antibodies aducanumab, lecanemab and donanemab, China offers only the investigational TCM-derived GV-971. No national long-term care insurance equivalent to Japan’s or Germany’s exists, leaving families to shoulder more than half of total costs.

To close these gaps, a four-pillar framework is proposed. First, create a State-Council-led China Dementia Prevention and Control Coordination Committee uniting health, science, education, civil affairs and medical-security departments, complemented by a Chinese Alzheimer’s Disease Association under the China Association for Science and Technology and a National Alzheimer’s Disease Center jointly run by the National Health Commission and TCM Administration. Second, build a three-level technical network: community-based cognitive screening integrated into annual physical exams, standardised memory clinics in every tertiary hospital equipped with diagnostic technology and TCM protocols, and specialised long-term care facilities supported by caregiver training and respite services. Third, launch a national dementia science-and-technology programme prioritising AI-enabled early detection devices, novel drug discovery, drug-repurposing trials, validation of TCM formulas, and non-pharmacological interventions such as qigong, music therapy and smart cognitive-training tools. Finally, strengthen policy safeguards by adding dementia to the chronic-disease management package, revising the National Essential Medicines List to secure supply and insurance coverage of dementia drugs, establishing an online patient registry for real-time surveillance, and expanding medical insurance to cover long-term and end-stage care.

Implementing these measures would yield a Chinese-style dementia care system that lowers under-diagnosis, expands specialist access, accelerates innovation and relieves family burden, thereby protecting national health and social sustainability.