Last year, as the proportion of Taiwan’s population aged 65 or older reached 20 percent, the nation became a super-aged society.
In a rapidly aging society, dementia can no longer be seen as the misfortune of individual households, but as a national-level challenge for public health, the long-term care system and National Health Insurance (NHI) sustainability.
A National Health Research Institute (NHRI) survey, showed tht about 350,000 people in Taiwan aged 65 or older have dementia, a prevalence rate of 7.99 percent.
This is projected to rise to 680,000 people, or 9.95 percent, by 2041, reflecting demographic change and growing care demand.
Dementia’s costs extend beyond medical expenses to family caregiving pressures and reduced workforce participation among carers.
The NHRI estimates average annual medical expenditure at NT$533,000 (US$16,959) per patient, 167 percent higher than for those without dementia.
Total national dementia-related care costs reach NT$345.7 billion annually, with lifetime costs per patient averaging NT$13.9 million, concentrated in moderate to severe cases.
However, Taiwan still lacks sufficient early detection and prevention policies, risking further strain on NHI finances and households.
International research highlights the importance of early intervention. A Journal of the American Medical Association study across 13 countries found tau protein tangles are a major driver of cognitive decline.
A study in Alzheimer’s & Dementia showed tau PET scans identified one in five additional cases in re-screening, demonstrating diagnostic value.
In Taiwan, 65 percent of dementia cases are in early to mild stages, creating a significant window for intervention.
Early detection can slow progression and preserve independence, treating dementia as a manageable chronic condition rather than rapid decline.
Taiwan already has strong foundations and capacity for early screening, diagnosis and treatment.
The Health Promotion Administration provides annual intrinsic capacity tests for those aged 65 or older and community-based early detection referrals.
Nationwide dementia care centers and integrated care networks are in place.
Diagnostic tools such as p-tau 217 blood tests and tau PET scans are advancing, while treatment is covered under NHI, including monoclonal antibody therapies introduced last year.
The gap lies not in ability but in coordination.
A national plan should include early health and economic evaluation, high-risk identification and screening models in the first one to two years, followed by expanded care networks and nationwide rollout in years two to three, alongside technology review and approval.
Policy priorities should include launching a nationwide early screening scheme by 2028 under the Healthy Taiwan Plan; shifting NHI reimbursement from fee-for-service to value-based care with smart healthcare systems and a national data platform; and establishing a cross-ministerial dementia taskforce under the Presidential Office or Executive Yuan.
Taiwan’s dementia strategy must be elevated to national planning, shifting from reactive care to early detection and prevention.
This is essential to reduce family burdens, stabilize NHI finances and position Taiwan as a global leader in dementia care.
Wu Shuh-min is a presidential senior adviser and president of the Foundation of Medical Professionals Alliance in Taiwan.
Translated by Gilda Knox Streader
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