Dementia Care in an Aging World: Achievements, Challenges, and Future Directions

As populations age worldwide, the number of people living with dementia continues to increase. Given the complex pathophysiology of dementia and its profound impact on individuals, families, and society, Japan and many other countries have developed and implemented dementia-related policies over the past two decades. Specific initiatives include the development of dementia care pathways, early-stage intensive support teams for community-dwelling people with dementia, dementia cafés, dementia care teams for hospitalized physically ill people with dementia, and workforce development programs related to dementia care. Building on these efforts, opportunities for people living with dementia to express their perspectives and actively participate in society have also expanded. As a result of these cumulative initiatives, Japan enacted the Basic Act on Dementia in 2023 and is currently in the process of formulating and implementing a national dementia plan based on this legislation. This review summarizes the achievements to date in dementia care, clarifies current challenges, and discusses future directions for dementia policy and practice. These experiences from Japan, one of the world's most advanced aging societies, may provide important insights for other countries facing rapid population aging.