As Taiwan becomes a super-aged society in 2025, with 20% of its population aged 65 and older, the challenge of dementia – particularly Alzheimer’s disease – continues to grow. According to research from the National Health Research Institutes (NHRI), nearly 8% of Taiwanese individuals over the age of 65, or approximately 350,000 people, currently have dementia. Of these, 60% are diagnosed with Alzheimer’s disease, the most common form of dementia. By 2041, the prevalence of dementia in people over 65 in Taiwan is projected to reach nearly 10%, meaning one in 10 elderly individuals will be affected.

The necessity, therefore, of early diagnosis and treatment to extend healthy life expectancy and improve patients’ quality of life cannot be understated. “Alzheimer’s disease progresses in stages, and intervention at the mild cognitive impairment (MCI) or early dementia stage can significantly delay the disease’s advancement,” says Dr. Hsu Jung-Lung, president of the Taiwan Dementia Society (TDS). Current data suggests that patients diagnosed in the moderate to severe stages often face disability, requiring full-time care and increasing healthcare costs.

“In Taiwan, we have established clear staging guidelines for cancers such as lung cancer and implemented low-dose CT scans for early detection,” says Dr. Hsu. “Combiend with the next-generation sequencing (NGS) to connect with precision treatment, we can see that the government is reducing the social cost of lung cancer mortality through early diagnosis and treatment intervention.” Moreover, Alzheimer’s disease is now clinically staged from 0 to 6, based on a combination of symptoms and biomarkers. Biomarkers such as amyloid PET scans, cerebrospinal fluid (CSF) analysis, and even emerging blood tests offer more precise early diagnostic tools. “We must treat Alzheimer’s disease as the ‘cancer of the mind’ and recognize the importance of anti-amyloid therapy to reduce the buildup of toxic proteins in the brain,” he notes. “We can reduce the disease burden by delaying the progression into the disability at the moderate-to-severe stage.”

Despite these advancements, Taiwan’s approach to Alzheimer’s disease diagnosis and management faces structural limitations. The Mini-Mental State Examination (MMSE), the current screening method that healthcare providers employ, can only provide cognitive assessments on the impairment but fail to determine its underlying cause.

“If a patient has chronic kidney disease, we wouldn’t stop at simply diagnosing the impairment – we’d investigate the cause,” Dr. Hsu says. “Yet with dementia, we often diagnose cognitive impairment without exploring the biological basis.”

To improve diagnostic precision, Dr. Hsu supports the adoption of advanced tools like plasma biomarkers, which offer a cost-effective, noninvasive screening method capable of being scaled for broader use. “In the future, with a simple blood test, we can determine whether a person has a high probability of developing Alzheimer’s disease with up to 90% certainty,” he says.

While PET scans remain the gold standard for diagnosis, their high cost and limited availability make them impractical for large-scale screening. “Taiwan has an opportunity to pioneer plasma biomarker implementation, setting a model for early detection in Asia,” Dr. Hsu says. However, the Taiwan Food and Drug Administration has yet to approve the use of plasma biomarkers in Alzheimer’s disease detection. We look forward to its availability in Taiwan in the upcoming years.

Another critical aspect of Alzheimer’s disease management is shifting Taiwan’s healthcare mindset. Historically, neurological and psychiatric specialists have approached degenerative diseases with a passive attitude. “For years, dementia care in Taiwan has been focusing on long-term care, which should be oriented toward early diagnosis and interventional treatment in the future,” Dr. Hsu says.

“In Taiwan, we don’t think of Alzheimer’s disease as causing death,” he adds. Alzheimer’s disease is often viewed as a slow decline rather than a critical health threat. “Healthcare providers often misattribute the cause of death to health complications resulting from Alzheimer’s disease rather than the disease itself.”

Education and awareness of dementia are crucial to shifting this narrative. Dr. Hsu commends the Taiwan government’s long-term care initiatives but emphasizes the need for greater focus on early detection. He also underscores the importance of lifestyle modifications in preventing Alzheimer’s disease, noting that risk factors such as hypertension, diabetes, obesity, smoking, and sedentary behavior contribute to cognitive decline.

He urges a multifaceted approach, incorporating cardiovascular health, mental stimulation, healthy diet, and social engagement to reduce the risk of Alzheimer’s disease. “Aging populations must be educated on the importance of exercise, a heart-healthy diet, and cognitive activities,” he says.

Taiwan’s pathway to improving Alzheimer’s disease management requires a collaborative effort from government agencies, healthcare providers, and the general public. By fostering early detection, advancing treatment options, and reshaping public perception, Taiwan can create a future where Alzheimer’s disease patients maintain their independence longer, easing the burden on families and society.

“Taiwan has a short window to respond to the rapid rise of Alzheimer’s disease cases,” Dr. Hsu says. “We need to take action now before the burden becomes overwhelming.”