Inequitable Access to Dementia Diagnosis and Care in Low-Resource Settings – A Global Perspective

Abstract

The Global dementia action plan 2017-2025 calls for universal access to care for people with dementia and their caregivers. Yet, health systems globally are ill-prepared to support the increasing number of people with dementia, especially in low- and middle-income countries (LMICs). This article discusses the differential effect of country-income and rural vs urban setting on dementia service delivery and accessibility using data submitted to the Global Dementia Observatory (GDO). While the majority of GDO countries provide community-based services for dementia, huge variability exists between high-income countries (HICs) and LMICs. Compared to LMICs, services for people with dementia and their caregivers are more frequently available and more universally accessible in HICs. Similarly, access to anti-dementia medication and the availability of health and social care facilities that provide dementia services is greater in HICs. Lower dementia diagnostic rates are partly due to a lack of trained workforce seen in LMICs. Disparities between HICs and LMICs are often systemic and reflective of inadequate policy responses. Without accelerated joint efforts at all levels, the world will not reach the global dementia targets by 2025, particularly in LMICs where the majority of people with dementia live and will continue to live.