The most revealing passage in the OECD's new dementia stocktake is not a finding at all. It is a line item. Denmark, the report records, allocated DKK 15 million for 2025 and DKK 20 million for 2026 through its Finance Act to strengthen regional dementia assessments by expanding capacity and reducing waiting times, on top of a 2024 health agreement (Sundhedsaftale) that earmarked more than DKK 123 million to upgrade assessment units, upskill staff and support safer prescribing, including of antipsychotics. That granularity is rare enough that the authors flag it as an exception. Their plain observation, set against a shelf of glossy national strategies, is that not all strategies come with designated funding allocations, or with the monitoring and evaluation plans that would show whether anything changed.
The document itself is OECD Health Working Paper No. 190, "Policies for people with dementia across OECD countries", published on 16 January 2026 by Soohyun Kim, Judit Rauet-Tejeda, Ricarda Milstein, Jinkook Lee and Ana Llena-Nozal, with a peer-reviewed version appearing in Alzheimer's & Dementia in June 2026. It is worth being precise about what kind of evidence this is: it is a review of policy documents, clinical guidelines and diagnostic pathways, not a study of patients. Nobody was enrolled, nothing was measured in a clinic. What it offers instead is the side-by-side view that has been missing. Thirty of 38 OECD countries, 78 percent, now have a stand-alone national dementia plan. Three fold dementia into something broader: Hungary into long-term care, France into a neurodegenerative diseases plan after it moved on from dedicated Alzheimer's plans in 2013. Estonia has no national policy but runs a Dementia Competence Centre with its own strategic plan. Eight countries carry more than one framework at once, either because plans exist at national and regional level, as in Spain and Portugal, or because separate legislation sits alongside the strategy, as with Japan's 2024 Basic Act on Dementia and Korea's National Responsibility for Dementia of 2017.
The unevenness starts once you ask how old these documents are. The report finds that 36 percent of countries have not revised the initial strategy they set before 2018, while 63 percent have brought in updates. Czechia, Germany, Iceland, Mexico and Poland, none of which had a strategy before 2018, have since put at least one in place. More are queued: new action plans are expected from Switzerland and Greece, Germany's strategy is due an update, and Czechia's is to be refreshed in 2026. Ownership is fairly consistent even where content is not; in roughly 76 percent of the countries examined (33 of 43), dementia policy is the responsibility of the health ministry. Consistency of authorship, though, is not consistency of delivery, and the report's own summary of the gap between policy and action is blunt about the variation in what actually gets implemented.
Where that gap bites hardest is at the front door: diagnosis. The authors describe diagnostic capacity failing to keep pace with demand as populations age, with shortages of general practitioners reported in Austria, Finland, Italy, Latvia, Portugal, Slovenia and Spain, and bottlenecks that translate into delays and unequal access to specialists and scanning equipment. Blood-based biomarkers are discussed as a genuine prospect for relieving some of those bottlenecks, on the grounds that they are accurate, non-invasive, affordable and less dependent on specialist assessment, but the report treats them as steady progress rather than an arrived solution, and it does not claim they have already closed anyone's waiting list. Then comes the harder sentence, the one families will recognise: professionals, people living with dementia and their families may have little incentive to pursue a diagnosis at all as long as suitable care options are not available afterwards. Research promises are easier to make than care capacity. Dementia research features prominently in almost 72 percent of countries' strategies and plans, yet concrete allocations are scarcer; Norway's Brain Health Strategy, with NOK 20 million channelled through the Research Council to establish clinical research centres for serious central nervous system diseases including dementia, is one of the few the report can point to with a figure attached. Switzerland is building a national monitoring system to track prevalence and care needs across the whole pathway, which is the sort of plumbing that lets a country find out later whether its plan worked.
The scale behind all this paperwork is not abstract. Across the OECD, an average of 61 people per 1,000 population aged 65 and over were estimated to be living with dementia in 2023, and the peer-reviewed version puts the worldwide annual cost at close to 1.3 trillion US dollars, rising as populations age. For a family, the practical question is never whether their country has a strategy. It is whether the strategy bought anything within driving distance: an assessment appointment this season rather than next year, a nurse who has been trained in dementia care, a named person who answers the phone when things change at 3am. This report can tell you, for the first time in one place, whether the document exists, who owns it, when it was last revised, and in a handful of cases how much money was attached. It cannot tell you what happens when you ring the number.