Absent a more proactive approach, the demographic shift could strain long-term care systems, social support, and the national health budget.
In the seven years from 2018 to 2025, Taiwan moved from being an aged to a super-aged society, with those 65 or older representing 20% or more of its population of 23.2 million. By 2050, 35% of Taiwanese are projected to be over 65.
Taiwan’s life expectancy has risen significantly since the mid-1990s – it is currently about 84 for women and 77 for men – thanks to the introduction of its National Health Insurance (NHI) system, which provides high-quality, universal, and affordable medical coverage to the Taiwanese people. At the same time as life expectancy as increased, the fertility rate in Taiwan — the among the lowest in the world last year at 0.7— has fallen sharply, resulting in a much larger elderly population.
As a result, Taiwanese society faces a larger disease burden. One of the biggest challenges to manage is dementia, and decades of low birthrates and the trend away from multi-generational households mean fewer family members are available to help provide care. Foreign caregivers often lack both fluency in Mandarin Chinese and specialized training for dealing with dementia behaviors.
About 350,000 Taiwanese — roughly 1 in 13 among those older than 65 — were living with dementia as of early 2024, according to Ministry of Health and Welfare (MOHW) data. The prevalence is about 8% for those aged 65 and older, increasing to over 29% for those aged 90 and older.
Dementia cases in Taiwan are forecast to continue rising steadily, reaching 470,000 by 2031. By 2061, the number is expected to increase to 880,000, according to the Taiwan Alzheimer’s Disease Association, a non-profit. Dementia is a general term for a decline in mental ability severe enough to interfere with daily life, which affects people mostly over the age of 65. Alzheimer’s is the most common form of dementia, accounting for 60% to 80% of cases.
Because Taiwan became a super-aged society so quickly, it has had less time to prepare for the uptick in dementia patients than Western countries, Dr. Hsu Jung-lung, president of the Taiwan Dementia Society, told Taiwan Business TOPICS in an interview. This fast rise in dementia patients has created large stress for [Taiwanese] society, because it has had very little time to respond,” he says.
While Taiwan has devoted considerable resources to long-term care for dementia patients, it has not yet made the same effort to address the needs of those in earlier stages of the disease. Preventative measures, particularly those focusing on social engagement for the elderly, also remain basic. Taiwanese society does increasingly emphasize healthy living, including regular physical exercise and a nutritious diet, but not as a way to prevent or delay the onset of dementia.
“The government wants to address later stage dementia first, but if we address early-stage disease first, we can delay later stage progression,” Dr. Bill Chan, Executive Medical Director, Taiwan and Hong at Eli Lilly and Company, said in an interview.
“Early screening is vital,” says Wayne Hsieh, Country Medical Director at Roche Pharma Taiwan. “Once diagnosed at a late stage, diagnosis poses greater treatment challenges.”
The burden extends beyond the patient. Dementia quietly reshapes families — disrupting careers, deepening isolation, and exhausting caregivers in ways that are not reflected in clinical data. “Effective care requires supporting not just the patient, but the entire ecosystem around them,” notes Mia Hsieh, Medical Advisor at Roche Taiwan. “We at Roche want to be a dedicated partner in this journey,”
One reason for the government’s approach is cultural. Many Taiwanese families choose to hire live-in caregivers for elderly family members with less-advanced dementia. “While this is aligned with international dementia care policies that emphasize home- and community-based care, the trend is also influenced by the shortage of professional dementia care institutions, cultural resistance to institutionalization, and the enduring values of Confucian filial piety,” noted a peer-reviewed article on Taiwanese live-in dementia care published by Sage Journals in July 2025.
The article, written by Taichung Medical University professor Yen Chia-Ming, found that family caregivers and their migrant employees faced several notable challenges with dementia care. “As family caregivers’ understanding of dementia evolved, they recognized the critical need to utilize public long-term care services to bolster the dementia-related knowledge and skills of their migrant employees,” Yen said. He suggests implementing additional dementia-specific training programs tailored for both family caregivers and live-in migrant care workers in Taiwan.
Scientific advances
Taiwanese researchers have been active in several areas that show promise for improving dementia diagnosis and treatment, including Alzheimer’s blood tests. These blood tests are significant because of their ability to provide a non-invasive and accurate (88%–93%) way to detect early amyloid plaques or tau proteins.
Amyloid plaques in a patient’s brain are “a hallmark sign of Alzheimer’s disease,” notes the U.S. Food and Drug Administration (FDA) on its official website. Though amyloid plaques can occur in other diseases, the ability to detect the presence of plaque, along with other evaluations, helps the doctor determine the probable cause of the patient’s symptoms and findings, the FDA says.
Tau is a protein primarily found in the brain’s messenger cells. In Alzheimer’s disease, an abnormal form of tau accumulates and begins sticking together in thread-like structures called neurofibrillary tangles. The build-up damages the brain’s microtubule superhighway and disrupts how neurons function, notes the BrightFocus Foundation — a non-profit that funds scientific research and providides public education to cure Alzheimer’s disease — in a 2014 article.
In April 2025, the results of a promising collaborative Alzheimer’s blood test study between Taipei Veterans General Hospital and South Korea’s Hanyang University were published in the peer-reviewed journal Alzheimer’s & Dementia. The study found that a simple blood draw of just a few cubic centimeters can effectively screen individuals at high risk of Alzheimer’s. Early diagnostic accuracy reaches up to 93%. Using this test to diagnose Alzheimer’s would only cost several thousand New Taiwan dollars, significantly less than the PET scans typically used in diagnosis.
One of the most notable findings of the study is a strong correlation between phosphorylated tau protein levels in blood and amyloid plaque buildup in the brain. Wang Shuu-Jiun, Deputy Superintendent of Taipei Veterans General Hospital, said in a news release that she is confident that the MOHW and its Food and Drug Administration would soon approve the test.
Fuh believes that once blood testing is adopted clinically, it could replace PET scans for Alzheimer’s detection. However, she acknowledged that further validation is needed. Fuh urges families to pursue early screening if they notice memory decline in elderly family members, “as timely intervention is key to better outcomes.”
