China, Macao SAR's Dementia Policy: Challenges and Prospects

China, Macao SAR's Dementia Policy was launched in 2016, aligned with WHO’s Global Action Plan on the Public Health Response to Dementia 2017-2025 and recognized by Alzheimer’s Disease International as the 27th globally. The Dementia Policy includes a 10-year strategic framework to promote dementia friendly communities across the region and aims to establish a dementia service network in China, Macao SAR. Directed by this policy, China' Macao SAR is striving to:

1. work with non-governmental organizations (NGOs) to provide citywide public education to increase public awareness and understanding of dementia;
2. streamline cognitive assessment and referral process;
3. strengthen integrated medical services and social care.

The objectives of the policy are to provide a seamless network to achieve early prevention, early detection, early diagnosis, early treatment and early support for people living with dementia and their caregivers. The Dementia Working Group, cognitive assessment network in Health Centers, Dementia Medical Center, and Dementia Support Center were established to achieve these objectives:

• The Dementia Working Group was set up to raise public awareness and understanding of dementia. 195 NGOs in the region have signed a charter to join the Alliance to build a dementia friendly China, Macao SAR. Other initiatives lead by the Alliance include to promote a healthy lifestyle, reduce the risk of dementia, detect dementia symptoms at an earlier stage, and raise public awareness and understanding of dementia.
• To achieve early diagnosis, the cognitive assessment network extended to all the 9 Health Centers throughout China, Macao SAR. The medical staff members from Health Bureau and community were trained to competently perform cognitive assessments.
• The Dementia Medical Center works with the Social Welfare Bureau to provide a seamless integrated medical service and social care for people living with dementia and their caregivers. The waiting time for consultation at Dementia Medical Center has been greatly reduced from more than six months to less than one month because of streamlined referral process.
• The Dementia Support Center offers comprehensive post-diagnosis services, including counseling, health education, training and support to people living with dementia and their families.

In addressing the requirements for information systems for dementia service, China, Macao SAR's Health Bureau set up a web page to disseminate information about dementia services and care. An electronic system was created to share information among all the 9 Health Centers and Dementia Medical Center. China, Macao SAR's Health Bureau also developed the Dementia Registry to collect data systematically.

These initiatives manifest that China, Macao SAR has taken great strides to improve waiting times, diagnosis rates, integrated care, and dementia friendliness through a seamless dementia service network between medical service and community care for older people living with dementia in China, Macao SAR.