Dai Xiuyu (fourth right), living with severe cognitive impairment, poses for a group photo with  a fellow senior staff member,  social workers and customers at the Unforgettable Cafe in Bailianchi Sub-District of Chengdu, Sichuan Province, on June 17, 2024 (XINHUA)

After brewing a cup of coffee, 85-year-old Dai Xiuyu suddenly forgets the steps she just learned and turns to a social worker for guidance—this scene replayed daily at Unforgettable Café in Chengdu, capital of southwest China's Sichuan Province.

Housed in the Ai'en Elderly Care Nursing Home, located in Chengdu's Bailianchi Sub-District—the first dementia-friendly sub-district in Sichuan, the cafe employs a staff that includes both young social workers and elderly individuals with cognitive impairments, including Alzheimer's disease (AD). 

The cafe officially opened in February 2024. Despite its compact size of 10 square meters, it is fully equipped to serve a range of freshly brewed coffees, such as Americanos and lattes.

"It serves as a bridge, enabling intergenerational interaction between the elderly with dementia and young consumers. It helps the elderly maintain a positive mindset and even slow down the progression of their disease," Su Youcheng, founder of the nursing home, told Xinhua News Agency.

Su said despite the varying symptoms, all patients with cognitive impairment share similar needs, both physical and emotional, such as respect, love and the realization of self-worth. "The non-pharmaceutical therapy has apparently helped improve their mood and reduce feelings of anxiety, irritability and restlessness.

Dai, living with severe cognitive impairment, once struggled with frequent disorientation and an obsessive need to visit the bank daily to withdraw cash. When her family resisted, her frustration often erupted into angry outbursts or physical aggression.

After transitioning to the nursing home, caregivers noticed that Dai thrived on heartfelt praise and validation. A simple compliment about her colorful scarf or sharp problem-solving skills could swiftly alleviate her distress.

In 2023, the Chengdu Civil Affairs Bureau began developing dementia-friendly communities as part of its public service project. The initiative aims to educate more elderly individuals about dementia prevention while providing non-pharmaceutical intervention training and family support activities for those already affected. As of January 2025, Chengdu had 56 such dementia-friendly communities. 

Aging minds, rising numbers 

The concern with senile dementia in China is rising as the population ages and life expectancy increases. According to the China Alzheimer's Disease Report 2024, jointly released in July 2024 by multiple institutions, including the Chinese Center for Disease Control and Prevention, AD, the most common form of senile dementia, affects over 5 percent of individuals aged 60 and above, rising to 30 percent among those aged 85 and older. The report projected that the number of AD patients aged 60 and above in China would reach 19.11 million by 2030, 24.71 million by 2040, and 27.65 million by 2050.

Ye Qinyong, Vice President of the Cognitive Impairment Branch of the Chinese Geriatrics Society and Deputy Director of Peking Union Medical College Hospital in Beijing, explained that AD progresses continuously and irreversibly. 

Early symptoms, often dismissed as normal aging, include subtle memory decline and reduced attention span. During the middle stage, AD patients exhibit pronounced behavioral and emotional instability, severe memory loss, language dysfunction, and disorientation. By the late stage, they lose all memories, language abilities and motor skills, potentially experiencing incontinence, difficulty swallowing, and convulsions.

"Misconceptions that AD is untreatable or not worth treating lead to most patients being diagnosed at advanced stages," he emphasized. "Early screening, intervention and treatment are critical to seizing the 'golden window period' for effective care."

Yu Jintai, chief neurologist at Huashan Hospital Affiliated with Fudan University in Shanghai, noted a significant rise in AD patients over the past five years. His hospital now sees 20,000 to 30,000 cognitively impaired patients annually, two thirds of whom have AD, with women twice as likely to be affected as men.

"Eighty percent of patients arrive at the hospital in middle or late stages, when interventions yield limited results," Yu told China Newsweek magazine. "This underscores the urgent need for public education to combat stigma and promote early detection."

He emphasized the critical role of grassroots doctors in early screening and diagnosis of AD, noting that as China's dementia patient population continues to grow, community physicians­—serving as frontline "health guardians"—could significantly improve diagnostic accuracy nationwide if equipped with stronger awareness and expertise in AD.

Bridging care gaps 

A severe shortage of cognitive health professionals remains a major barrier to dementia prevention, particularly at the grassroots level. Tang Yi, Deputy Director of the National Center for Neurological Disorders, highlighted that in 2021, China had only 2,000 cognitive disorder specialists, mostly concentrated in large top-notch hospitals, revealing a vast gap in specialized care between large and primary healthcare institutions.

To address this, the National Health Commission (NHC) launched a project in 2021, focusing on training three types of professionals: cognitive disorder specialists, cognitive rehabilitation therapists and neuropsychological assessors. Tang, head of the expert panel of the project, introduced that through hybrid online and offline programs, over 5,000 professionals have been trained nationwide, 67 percent of whom are from grassroots-level institutions.

In early January, China launched a national action plan to tackle the escalating challenge of dementia. Jointly issued by 15 government bodies, including the NHC and the National Development and Reform Commission, the plan outlined a roadmap to establish a comprehensive dementia prevention, diagnosis, treatment and care system by 2030. Key goals included controlling the rising prevalence of the disease through nationwide cognitive screenings for the elderly and ensuring early interventions for at-risk individuals.

The plan emphasized standardized medical services, expanded access to rehabilitation and enhanced care infrastructure. By 2030, half of all large elderly care institutions (with 100 or more beds) are required to establish dedicated dementia care units, while 15 million caregivers will receive specialized training. These measures aim to alleviate the societal and familial burden of dementia, offering hope for millions of families going through difficulties resulting from cognitive decline.

"I hope we can establish a nationally replicable and scalable comprehensive brain health management model in the future," Chen Xiaochun, head of the Neurology Branch of the Chinese Medical Doctor Association, told newspaper Fujian Daily.

Regarding the immense burden of caring for AD patients, Chen proposed expanding community-based AD care centers to provide specialized support for those with cognitive and functional impairments. He also urged integrating AD into chronic disease management frameworks and including it under long-term care insurance coverage to ease financial strains on end-stage patients and families.

"All our efforts aim to ensure seniors can age with dignity and quality of life," Chen said. BR

(Print Edition Title: Memory's Last Stand)    

Copyedited by G.P. Wilson 

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