Global Dementia Care Crisis: 1 in 5 Receive No Support

One in five people with dementia receive no care, global study finds

Written by Zoe Beketova

As the world's population rapidly ages, a new study led by researchers at the Yale School of Public Health finds that people living with dementia are struggling at an alarming rate. Heightening the sense of despair is an additional finding that this lack of care has persisted for years.

Globally, at least 1 in 5 people living with dementia are receiving no care to help them with daily living, regardless of the wealth or development status of their country, according to the study published in Nature Aging. The journal also published a related article authored by Chen.

"This is not just a care issue; it's a public health crisis," said Dr. Xi Chen, Ph.D., associate professor of public health (health policy) at the Yale School of Public Health and the paper's senior author.

The study analyzed data from more than 10,000 individuals across the United States, England, 18 European nations, Israel, and China. It is believed to be the most comprehensive cross-national investigation to date into the caregiving experiences of people living with dementia.

Research Methodology

The research drew from four large-scale longitudinal surveys:

• The U.S. Health and Retirement Study (HRS)
• The English Longitudinal Study of Aging (ELSA)
• The Survey of Health, Aging and Retirement in Europe (SHARE)
• The China Health and Retirement Longitudinal Study (CHARLS)

Participants were adults aged 50 and older who were residing in the community and had been identified as living with dementia. All faced at least one limitation in basic or instrumental activities of daily living, such as bathing, dressing, preparing meals, paying bills, and managing medications.

Key Findings

The researchers discovered that approximately 20% of individuals living with dementia received virtually no care in their day-to-day lives, regardless of whether they lived in a wealthy, middle- or low-income country or their country's cultural approach to health care. Notably, there was no evidence that the global care gap narrowed between 2012 and 2018, the period covered by the study.

Dr. Chen expressed surprise over the consistency of findings across countries, stating "No matter how developed a country is, the care deficit has persisted over time for at least the last 10 years."

Gaps in Dementia Care

The study highlighted significant gaps in both formal and informal caregiving.

• Formal caregiving: Professional or paid services provided at home or in nursing homes.
• Informal caregiving: Care provided by family or friends.

In terms of formal care, nearly 99% of people with dementia and daily limitations in China reported receiving no formal care. The U.S. fared only slightly better, with 86% lacking formal support. Even in Europe and England, where social care systems are more developed, over 70% of participants went without formal assistance.

Although somewhat more common, informal care was also alarmingly insufficient—about one in four individuals with dementia reported receiving no informal care.

Economic Implications

These findings come as countries worldwide adjust to a rapidly growing global population of people aged 65 and older. In 2022, over 55 million people globally were living with dementia, a number projected to rise to 139 million by 2050.

Dementia affects cognitive abilities severely enough to interfere with daily life. An estimated 6.9 million Americans are currently living with dementia, leading to significantly greater caregiving needs and health care costs than those with other conditions. Projected health and long-term care costs related to dementia are expected to reach $360 billion in 2024 and nearly $1 trillion by 2050, according to the Alzheimer's Association.

Closing Gaps in Dementia Care

Addressing dementia care gaps requires a multifaceted approach, including:

• Significant financial investment to improve access to care.
• Increased professional caregiver staffing.
• Greater support for informal caregivers worldwide.

Dr. Chen emphasized the importance of understanding cultural nuances and regional demographics when developing solutions. He urged policymakers to prioritize effective and context-specific care models for individuals with dementia.

"To close these care gaps, we need transformative policy changes, more funding for formal care, and better support for informal caregivers," said Dr. Chen. "Without action, the burden on families and the consequences for older adults will only grow more severe."

Literature Cited

[1] Lin, Z., et al. (2025). Absence of care among community-dwelling older adults with dementia and functional limitations. Nature Aging.

[2] Chen, X. (2025). Alarmingly large care deficits globally for people living with dementia and disability. Nature Aging.

**Retrieved from** Medical Xpress on April 2, 2025.