Dementia accounted for more than 1 in 10 deaths in Australia for the first time in 2025. It was associated with 19,019 deaths, or 10.1% of all deaths in the country last year, according to recent Australian Bureau of Statistics data. Dementia has been Australia’s leading cause of death since 2024. Is the country’s healthcare system adequately prepared for the growing burden of the disease? 

Aged care is assuming growing importance, and healthcare professionals must be prepared to recognise, diagnose, and manage conditions that disproportionately affect older patients. Clinicians will increasingly need the skills to identify early signs of dementia, distinguish them from other causes of cognitive impairment, manage age-related comorbidities, and coordinate care across primary, specialist, and community services. Evidence-based clinical guidelines and continuing professional education will be important in supporting these efforts. 

The challenge is likely to intensify as Australia’s population ages. According to the Australian government’s population projections, people aged 65 years and older are expected to account for about 24% of the population by 2064-65, compared with 17.3% in 2022-23. 

The government may need to reassess its healthcare priorities in light of this demographic shift. Public health campaigns aimed at improving awareness and early recognition of dementia and other age-related conditions might receive greater attention. Governments will be asked to ensure adequate funding for programs supporting older people, including continuing education and training for healthcare professionals, timely access to primary and specialist care, and home-based care services.

Why Dementia Goes Undiagnosed 

The growing proportion of deaths attributed to dementia reflects Australia’s aging population, with more people living to ages at which dementia is more common, according to Lee-Fay Low, PhD, a registered psychologist and dementia researcher in Sydney specialising in aging and aged care. 

A deeper issue may also be contributing to the trend, however. Up to half of patients with dementia remain undiagnosed, suggesting that many are not being identified early enough to access appropriate interventions. 

The Australian Institute of Health and Welfare’s recent Living with Dementia Survey highlights the delays involved. Fewer than half of respondents received a diagnosis within a year of first noticing symptoms, while 3 in 5 received one within 3 years. More than 1 in 4 (27%) said they waited over a year after noticing symptoms before seeking professional advice. 

One reason for these delays is that dementia develops gradually, and its early symptoms can be mistaken for normal, age-related memory decline. Older people may therefore attribute changes in their memory to aging rather than recognising them as possible signs of dementia. Other conditions, including stress and depression, as well as medication side effects and poor sleep, can also affect memory, potentially complicating recognition of the underlying problem. 

Furthermore, stigma surrounding dementia may discourage patients from seeking an assessment. Some patients with the condition are made to feel that they are past their prime and have little left to contribute. This may be a particular concern among working-age adults, who may fear that a diagnosis could jeopardise their employment or career prospects. 

A patient’s broader clinical and social circumstances can complicate the diagnostic process, said Perminder Sachdev, MD, PhD, a neuropsychiatrist and Scientia Professor of Neuropsychiatry at the University of New South Wales Sydney. 

“Diagnosis can be especially complex when a person has multiple conditions, a less typical presentation, or needs assessment in a language or cultural context for which appropriate services are not readily available,” he told Medscape News Australia. “Access to specialist assessment and diagnostic tests can also be harder outside major cities.” 

Even when patients decide to seek an assessment for dementia, access to timely diagnosis and treatment is not guaranteed. There are several barriers in Australian primary care, Low noted, including general practitioner shortages in some regions and difficulties recognising early signs of dementia. These challenges may result in symptoms being attributed to normal aging or patients’ concerns not being adequately investigated. 

Barriers persist after diagnosis, particularly for patients living in regional and rural areas, where specialist services and memory clinics are less accessible. A recent Australian study found that patients in rural areas faced longer waits for an initial appointment at a memory clinic, with median wait times up to 28 days longer than those living in metropolitan areas. Access to more advanced diagnostic investigations, including functional neuroimaging, was also more limited. 

Strengthening the Dementia Care Pathway

Australia’s National Dementia Action Plan 2024-2034 is a 10-year framework developed jointly by the federal, state, and territorial governments. Its eight priorities include improving dementia awareness and tackling stigma, reducing risk where possible and delaying onset, strengthening diagnosis and postdiagnostic care, improving treatment and coordination, supporting carers, maximising the impact of dementia research, and building workforce capacity. 

But reforms have not kept pace with the growing scale of the problem, said Low, citing gaps in support before and after diagnosis. Patients who need assistance to continue living independently at home may struggle to obtain it, while newer disease-modifying treatments, including monoclonal antibodies, remain financially inaccessible to many patients. In Australia, donanemab and lecanemab are available privately but are not subsidised through the Pharmaceutical Benefits Scheme. 

Improving dementia care requires strengthening the entire pathway, rather than placing disproportionate emphasis on new medicines, Sachdev argues. Timely assessments must be made more accessible by expanding diagnostic services, telehealth, and culturally appropriate care, he added. Diagnostic capacity should also be improved to ensure that eligible patients can access appropriate brain imaging and validated Alzheimer’s disease biomarkers. 

Support must continue beyond diagnosis, including psychological care, education for carers, and flexible home-based services, Sachdev continued. He also advocates for investment in the dementia workforce, spanning both primary and specialist care, alongside better monitoring of access and patient outcomes to strengthen accountability. 

Prevention should form another central component of Australia’s dementia strategy. Modifiable risk factors, including smoking, physical inactivity, diabetes, and high blood pressure, warrant greater attention through public health interventions. 

“Prevention will not eliminate dementia, but it can reduce or delay some cases,” Sachdev said. “Australia has important foundations, but the scale of need is growing, and care remains difficult to navigate for many people and families.”

Low and Sachdev reported no relevant financial relationships.