[MapEA Project: evolution of care for Alzheimer disease and other dementias in Spain (2017-2024)]

Alzheimer disease (AD) is the most common cause of dementia and represents a major health and social care challenge in Spain, with an estimated prevalence of 700,000-800,000 affected individuals. The Map of Alzheimer's disease and other dementias in Spain project, MapEA, launched in 2017, revealed territorial heterogeneity, diagnostic limitations, and deficits in care coordination in the management of AD. Consequently, an updated assessment was conducted in 2024 to identify progress, areas for improvement, and recommendations to optimize comprehensive care. A four-phase study was carried out, including a literature review, the development and validation of a digital questionnaire distributed to 138 professionals from different fields, analysis by autonomous communities, and integration of the information through descriptive and thematic analyses with the participation of a multidisciplinary Advisory Committee. The results showed a low to moderate level of implementation and awareness of national strategies, with only four autonomous communities having specific regional plans. Compared with 2017, a reduction in care resources was identified, although a significant increase was observed in the availability of diagnostic technologies and in the number of specialized training positions. Survey responses indicated substantial clinical research activity; however, delays in diagnostic testing persisted, along with unequal availability of non-pharmacological therapies, often dependent on private funding or co-payment. The care pathway continued to show interregional heterogeneity and coordination challenges between levels of care. Overall, the MapEA 2024 findings demonstrate progress in diagnostic capacity, training, and research, but also highlight territorial inequalities and persistent gaps in coordination, human resources, and equity of access, underscoring the need to strengthen professional training, integrate health and social care services, and ensure structured support for patients, families, and caregivers.