In 2019, I met the health minister of a populous nation. After spending 30 minutes discussing the country’s dementia statistics, the minister politely stopped me mid-sentence — and asked whether I could define dementia. They had never heard the term before.
This is not an isolated incident. As the chief executive of Alzheimer’s Disease International (ADI), I’ve had more than one government minister tell me that their country is completely dementia-free. ADI’s 2024 World Alzheimer Report found that 65% of health-care professionals surveyed globally thought that dementia was a normal part of ageing — not a condition caused by a disease (see go.nature.com/3sxtjwj).
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There are many factors behind this global lack of awareness. Dementia’s biological causes are complex and poorly understood, making them hard to explain to people without a scientific background. There’s a stigma associated with the condition that can make people unwilling to engage. And, perhaps because of this stigma, the first organizations to support and advocate for people with dementia weren’t set up until the 1980s — decades after comparable ones for people with cancer.
However, in my view, the condition’s invisibility is also partly attributable to a failure of the World Health Organization (WHO) and the United Nations to class dementia as one of the world’s deadliest non-communicable diseases (NCDs). Inclusion of dementia in these organizations’ discussions about NCDs could drastically change attitudes worldwide — and could improve access to care and support for people living with the condition and their carers.
In September, there will be a chance to gain this recognition. During the UN’s fourth high-level meeting on the prevention and control of NCDs and the promotion of mental health and well-being, member states aim to develop a political declaration to chart how the world will address NCDs over the next five years.
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Here’s why dementia must be part of that declaration.
The UN’s first high-level meeting on NCDs, in 2011, centred on a group of conditions known as the WHO’s ‘big four’ — cancer, cardiovascular diseases, chronic respiratory diseases and diabetes. Being on this list has mattered ever since. The WHO uses it when proposing cost-effective interventions to prevent and control NCDs. Cash-strapped governments use these recommendations to allocate funds.
But the list is outdated. It is based on the numbers of people killed by NCDs before the age of 70. That might have made sense when the big four were first established — but today, people globally are living longer. In the United Kingdom, for instance, 2017 data showed that men aged 70 and women aged 72 had a remaining life expectancy of 15 years. Those ages are expected to rise.
