Advancing dementia care: a review of Italy's public health response within the WHO Global Action Plan and European strategies

Abstract

Introduction: Dementia is a growing global public health priority, with the WHO Global Action Plan (GAP) calling for coordinated efforts worldwide. Italy, one of the oldest nations globally, faces a significant challenge with approximately 2 million individuals living with dementia or mild cognitive impairment. In response, the Italian Fund for Alzheimer's and other Dementias (IFAD) was established in 2020 to align national efforts with the WHO GAP's objectives. This study analyses IFAD activities from 2021 to 2023, offering insights into Italy's public health response to dementia and its relevance to global strategies.

Methods: We conducted a structured, iterative review of all activities coordinated by the Italian Dementia Observatory (OssDem-Istituto Superiore di Sanità (ISS)) within IFAD 2021-2023. Global, regional and national documents on dementia prevention, care and support were retrieved from official websites, institutional repositories and targeted web searches using the keywords 'dementia', 'brain health' and 'ageing'. Two reviewers independently screened and extracted data with a predefined matrix mapped to the seven WHO GAP Action Areas. Human-subject studies cited had independent ethics approval and informed consent; no new data were collected for this review.

Results: IFAD activities led to substantial progress in dementia care services, with memory clinics, residential care facilities and daycare centres mapped, revealing regional disparities in service provision. Modifiable risk factors accounted for 39.5% of dementia cases in Italy, with an estimated 67 000 cases preventable through risk reduction. National guidelines were developed to standardise dementia care pathways, and training programmes addressed gaps in HP and caregiver preparedness, particularly highlighted by the COVID-19 pandemic.

Discussion: Italy's experience provides valuable lessons for countries facing similar demographic challenges. The IFAD extension to 2024-2026 aims to address persistent regional disparities and further implement national guidelines and prevention strategies. By integrating Italy's progress with broader international frameworks, the Italian model can inform global efforts to enhance dementia care, highlighting the importance of scalable, regionally adapted strategies for addressing the growing global burden of dementia.

Keywords: Epidemiology; Mental Health; Public Health.

Figure 1. IFAD 2021–2023 activities organised by WHO GAP action area. The activities falling under action areas (AAs) 1 to 6 operate independently and ensure a continuous exchange of knowledge across multiple channels and targets. Data from these activities are useful within other research and innovation activities (AA7), which will increase the exchange of knowledge and consequentially determine the mutual improvement of the activities under AAs 1 to 6. GAP, Global Action Plan; IFAD, Italian Fund for Alzheimer’s and other Dementias.

Figure 2. Key WHO GAPs outlining the life course approach to promote healthy brain ageing. This infographic shows the comprehensive approach to promoting healthy brain ageing, as described in the most relevant WHO action plans. The diagram includes three circles, with (1) the GAP on dementia, (2) the IGAP on epilepsy and other neurological disorders and (3) the GAP on ageing. Each segment of the circle of the GAP on dementia represents one of the action areas (AAs), while each segment of the circles of the GAP on ageing and IGAP on epilepsy and other disorders represents one of the strategic objectives (SOs). The lines on the background are the activities carried out within the framework of the Italian Fund for Alzheimer’s and other Dementias (IFAD) 2021–2023 and described in online supplemental Table 74). GAP on dementia: AA1—dementia as a public health priority; AA2—dementia awareness and friendliness; AA3—dementia risk reduction; AA4—dementia diagnosis, care and support; AA5—support for dementia carers; AA6—information systems for dementia; AA7—dementia research and innovation. IGAP on epilepsy and other neurological disorders: SO1—raise the prioritisation and strengthen governance; SO2—provide effective, timely and responsive diagnosis, treatment and care; SO3—implement strategies for promotion and prevention; SO4—foster research and innovation and strengthen information systems; SO5—strengthen the public health approach to epilepsy. GAP on ageing: SO1—commitment to action on healthy ageing; SO2—developing age-friendly environments; SO3—aligning health systems to the needs of older populations; SO4—developing sustainable and equitable systems for providing LTC; SO5—improving measurement, monitoring and research on healthy ageing. GAP, Global Action Plan; IGAP, Intersectoral Global Action Plan; LTC, long-term care.