Health » Overview

Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series of seminars to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.


Interviews and coverage from our Health programs

Fellows to Produce Salzburg Statement Focused on Dementia-Friendly Communities
Fellows to Produce Salzburg Statement Focused on Dementia-Friendly Communities
Tomás De La Rosa 

Participants from 14 countries have agreed to develop a Salzburg Statement to use as a framework when approaching governments and organizations on dementia care issues.

The decision was made on the fifth day of the Salzburg Global session,
Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, which is part of the multi-year series Health and Health Care Innovation in the 21st Century.

Leading up to this, 40 participants had spent four and a half days discussing the stigma surrounding dementia and what a dementia-friendly community entails.

They also took part in plenary sessions addressing various aspects of life with dementia, including how innovations in dementia care can reduce the stigma surrounding the condition and make a difference in people’s lives. Participants also reflected on the benefits of a timely diagnosis and the role of arts in mitigating the impact of dementia.

On the fifth day of the session, participants presented six sets of recommendations addressing different elements that make up dementia-friendly communities and how to apply them in a global context.

After their presentations, participants agreed a Salzburg Statement would be the prime vehicle to bring together these proposals and take decisive action moving forward.

The first group, which addressed community empowerment, produced a strategy oriented toward giving self-confidence to people with dementia and the people around them through education and tools, active engagement in professional care, and knowledge of their legal rights and how to access them.

Through this approach, they hope to help create more safe spaces for people with dementia through professional acceptance of family leadership, community networking and social conversation platforms, and the creation of a general environment of inclusiveness and dignity.

The second group looked into research priorities within dementia-friendly communities. These were established based on the needs of those living with dementia and their carers. The first of these priorities focused on issues such as the role communities can play in screening and addressing people with dementia and caregivers at the time of diagnosis and providing initial educational and care plans.

The second priority was community-based care and services, which includes focusing on support for challenges people with dementia may face, caregiver support, and supportive social structures. The last priority suggested looking at alternatives to institutionalization for people with disabling dementia, how to manage complications, and how to make end-of-life care more humane.

The third group designed a roadmap providing guidance for effective dementia education and training programs. Its elements included target groups; skills, knowledge, and attitudes at different levels; consideration of needs; learning methods; insurance of accessibility; and culturally appropriate systems. Through it, the group hopes policymakers, educators, local communities, researchers, individuals, and institutions, would be able to design more effective dementia-friendly communities.

Inspired by their meetings in Schloss Leopoldskron's Max Reinhardt Library, the fourth group proposed the creation of an information library on dementia. It would be publicly accessible and professionally curated in consultation with dementia-friendly initiatives. The library would also introduce Wiki-style entries for dementia-friendly projects and organizations, which would contain work details such as their mission, goals and progress, contact details, location, and crowdfunding links.

The fifth group focused on dementia-friendly innovations in medical care. Their project looked into how communities and individuals can have a role in health facilitation for front-line staff, such as medical carers, to learn the needs and wants of people with dementia. Through this, they’d be able to provide care navigation, resources to a wider team in more complex issues, and prepare for life-course stages.

The final group explored the steps to build on to further awareness in dementia-friendly communities. This "Global Communication Network on Dementia" would help transform ideas into actions across various countries. This group suggested the moment is prime for introducing the project, as there is a "worldwide need for an open source network." Among other actions, this would allow people to exchange best practices for care and build awareness of how communities can be dementia-friendly. The network’s core belief is, "Together we can build bridges, relationships to broaden horizons and inspire each other to improve the lives of people with dementia and carers."

Veronique Roger, a representative from session partner Mayo Clinic, said the outcomes from this session would allow the different parts of dementia care to be more synergistic. To finish she added, "We have an opportunity to go after the goals we have set for ourselves [...] It will never be enough, but if we start now we will have more than what we started with."


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Innovation in Dementia Care - Building Inclusive Communities
Innovation in Dementia Care - Building Inclusive Communities
Salzburg Global Seminar 

The third day of Changing Minds: Innovations in Dementia Care and Dementia Friendly Communities started with two different panels on dementia-friendly work.

The sentiment echoed throughout the morning was that becoming a dementia-friendly community is an ongoing process. Participants debated what it meant to be dementia-friendly, and whether being dementia-friendly always means being dementia inclusive and dementia capable as well.

The first panel enabled participants to develop a greater understanding of the work that takes place in dementia-friendly communities and what happens behind-the-scenes.

The conversation began with Jason Foo explaining the ongoing work in Singapore, which has included training Dementia Friends and dementia-friendly organizations. More dementia day care centers have also been set up.

Foo, the chief executive officer of the Alzheimer’s Disease Association in Singapore, said he and his colleagues recently explored the question: is having a dementia-friendly community the same as being dementia inclusive? As an add-on to that matter, what does dementia inclusive entail?

For something to be dementia inclusive, it must be empowering and provide freedom of choice for the person with dementia, Foo said. This way of thinking was reaffirmed when Foo and his colleagues had a conversation with someone with younger onset dementia. She told Foo and others she had the right to claim back her pre-diagnosis life.

For example, while building more dementia day care centers is a positive step, people with dementia who attend them shouldn’t be made to feel they are being locked up. Foo said he and others considered how places and activities could be made more dementia inclusive, which is one step further from being dementia-friendly so that people with dementia can have a real quality of life and dignity.

DY Suharya, founder of Alzheimer Indonesia (ALZI), and the regional director of Alzheimer’s Disease International Asia Pacific Region suggested a dementia-friendly community is defined as a place or culture where people with dementia and caregivers are empowered, supported, and included. This means understanding their rights and recognizing their potential.

When she established Alzheimer Indonesia, she paid particular attention to its branding and the messages it communicated. The tagline, “Do not underestimate memory loss,” was created following two months of discussion. Suharya said every country and city could have their own methods for raising awareness, but the bottom line is activating people’s potential to support people with dementia.

Fellows from Indonesia shared an example of the campaign held by ALZI, where people wearing purple campaign shirts take photos of themselves at famous landmarks. This encouraged more and more people to get involved, causing a snowball effect.

When identifying a dementia-friendly community, it is important to establish who the primary service provider is and its level of capability. That was the view of Kate Gordon, a health policy analyst and grassroots advocacy strategist. Just because a program may have served people with dementia for a long time, it doesn’t mean it is the most capable.

Organizations that provide services for people who potentially live with dementia should strive for training periodically to make sure staff know best practices when it comes to recognizing the condition, have effective communication skills and be able to refer people with dementia and their caregivers to specialized services.

Participants were introduced to a free tool which can assess organizations and how capable they are. In some cases, organizations may feel attacked when having to review their performance, but this is an efficient way of helping communities move forward. It is also a useful tool for decision-makers to see what progress has been made.

Reducing stigma was once again brought forward as a method to make communities more dementia-friendly. In countries like Nigeria, where a word for dementia doesn’t exist, providing more information on the condition through the work of the ambassadors has proved to be a valuable way to help the local communities. One participant noted that southern states in the United States often had similar challenges to countries like Nigeria, regarding lack of knowledge and their attitudes toward dementia. Promoting understanding of the condition would help ensure high-quality care.

The possibility of creating a global symbol for dementia-friendly initiatives was discussed. While the benefit of unified symbols was seen, a participant said the focus should be on breaking down the unique problems of each sector and the challenges posed by different public institutions.

Another participant remarked that labels are not important. Ensuring that the community steps in to help is the key, and people don’t shy away when they see a confused person.

Building a movement around dementia care, and activating existing communities is a positive way of moving forward. A participant from the UK noted volunteers want to become increasingly involved in the dementia cause.

Collaboration, identifying the champions and reaching out to them was seen as the key to building a successful campaign. Several participants said there was a need to keep the individual with dementia in mind – whether it was to plan movements, evaluate services or build inclusive communities.

Global networking, sharing successful case studies across the world, and pooling together the knowledge of caregivers were other valuable means.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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William Hu - “There’s a lot of good work going on, but not enough credit is given to the people”
William Hu - “There’s a lot of good work going on, but not enough credit is given to the people”
Mirva Villa 

“I hope that we can come up with a concrete action plan to disseminate and share the best practices in dementia-friendly initiatives and communities,” says William Hu, speaking on the third day of Changing Minds: Innovations in Dementia Care and Dementia.

Hu, an assistant professor of neurology at Emory University, has his eyes set on the future. Trained
as a neurologist and neuroscientist, Hu spends a lot of his time working toward improving the early diagnosis of dementia, and for the past two years has been involved in promoting dementia-friendly communities.

“We have been trying really hard to have an international forum where the lessons from the countries that have been doing dementia-friendly communities for some time can be shared with other countries that are just gearing up to do this.”

When Hu heard about this Salzburg Global session, he saw its potential in contributing to global efforts on improving dementia care.

“I was very excited when I heard that this was happening,” he says. “This really is a continuation of the global effort to talk about what a dementia-friendly community actually means, and how we get there.”

There are great efforts globally toward creating dementia-friendly initiatives and promoting inclusive communities, but several challenges hinder the rate of progress.

Hu says, “One is finding a driver for the initiative. Most of us are doing this as addition to our day jobs, and so finding somebody who will take it on as their primary focus has been a challenge not only felt in the States but also elsewhere.

“Number two, [the] challenge really is the resources and funding. How are you going to get the signage [and] the website hosting? How are you going to pay for travels to learn dementia-friendly practices from elsewhere?

“And finally, a huge challenge is convincing decision-makers that this is something worthwhile doing. The decision-makers usually have a set of goals of their own, and now we’re trying to convince them that having a dementia-friendly community or practice is a positive thing. But how do we compete with other goals such as profit margins, quality measures and the request of shareholders?”

Hu’s day job is closely linked to the dementia cause. His laboratory focuses on using spinal fluid, plasma imaging and neuropsychological measures to provide the most accurate diagnosis as early as possible.

“What that means is that whenever somebody has very mild symptoms of forgetfulness or word-finding difficulties, we can tell very early on whether the Alzheimer’s changes are present in the brain,” says Hu. Part of his research is patient-oriented, which has allowed him to frequently meet people with dementia, with the conversations going beyond the clinical responsibilities of Hu’s work.

“We get to hear a lot about their concerns on the day-to-day level, which is really what got me into dementia advocacy and dementia-friendly communities.”

Speaking further on what kind of actions he hopes to come out of the session, Hu hopes to see ways of recognizing and promoting the work of ordinary people in dementia care.

“I know firsthand that there’s a lot of good work going on but not enough credit is given to the people who do the good work. A lot of the time it’s the people who have been trained by the professionals, so it’s regular citizens doing the good work. How do we feature these people?”

Hu reflects on the story of two customs officers at Heathrow Airport, who went out of their way to help out a woman confused about where she was traveling. “I’m sure that was not in their job description, but they did it. So how do we reward them, and how do we provide incentives for others to follow their example? That’s what I’d like to get out of this.”

A lot remains to be done for dementia-friendly communities. What motivates Hu to keep working in this field?

“The spirit of people living with dementia and their caregivers. It’s very inspiring to talk to them and hear of their life’s accomplishments and what they still hope to accomplish in spite of the disease. There is a strong human will in illness that comes out, and I’m constantly humbled by interacting with people living with dementia and hearing what insight they have into the disease, but also bigger things in life.”


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Supporting People with Dementia From the Point of Diagnosis
Albert Mulley co-chairing a panel on the advantages and disadvantages of earlier diagnosis
Supporting People with Dementia From the Point of Diagnosis
Salzburg Global Seminar 

“Earlier diagnosis is not optional; it is a human right.” This was one argument put forward during a late morning discussion on the second day of Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.

Session co-chair Albert Mulley invited participants to share their views on the advantages and disadvantages of earlier diagnosis and the net value it would bring in different contexts.

Participants also considered how families and supporters could be better assisted after diagnosis in planning and shared decision making for the future.

Mulley, managing director for global health care delivery science at The Dartmouth Institute, suggested earlier diagnosis provided the potential to identify populations at risk. One participant, who lives with dementia, said a timely diagnosis did allow him to explain his irregular behavior, but it
was more important to him to have the correct diagnosis.

One participant indicated diagnosis as a concept hadn’t been examined enough, arguing, “We say diagnosis, but we mean prognosis. We want to know what happens in the future.”

A timely diagnosis could serve both a social and medical function, participants heard. It enables people to explain how they’re feeling and allows their peers to understand what they’re going through.

If someone receives a timely diagnosis, they are able to access the best kind of support: that of their peers. One participant said, “How can you have access to peer support if you don’t know who your peers are in the first place?”

An early diagnosis does not come without its downsides, however, as the group soon learned.

One participant argued moving up the time of diagnosis allows people to be able to control further aspects of life, as well as giving more peace of mind. He added, “On the other hand, earlier diagnosis has the chance of increasing stigma.”

Participants were also reminded to err on the side of caution when scanning for certain diseases before they became medically apparent. One participant warned it was more likely non-progressive diseases would be found.

The downside of an early diagnosis, and the potential of misdiagnosis that comes with it, could be the risk of the patient developing mental health conditions, such as anxiety or depression. If a timely diagnosis is to be made, it is important to ensure the structure of both public and private health systems are renewed.

While highlighting an area of the Pacific Islands that only has access to two dementia specialists, a participant used this as an example to argue how important it was to develop tools that allow timely diagnosis regardless of context and location.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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DY Suharya - My Work is a Thank You to My Mom
DY, pictured above, has more than 20 years of experience in public health, public private partnerships and communication
DY Suharya - My Work is a Thank You to My Mom
Mirva Villa 

“Soulful calling.” That’s how DY Suharya describes her work in raising awareness on dementia and working toward improving the quality of life of people with dementia and their caregivers. She is the founder of Alzheimer Indonesia, and the regional director of Alzheimer’s Disease International (ADI) Asia Pacific Region, overseeing 17 countries.

“I have this lifetime commitment to share with people, especially in the Asia Pacific, how you deal with it, how you prevent, reduce your risk, and how you empower, equip and provide support for people with dementia and caregivers, and advocate for person-centered care,” says Suharya. She raises the point while speaking at the Salzburg Global Seminar session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.

The Asia Pacific countries are diverse, but there are some commonalities in terms of challenges with dementia care. One of the biggest challenges is providing support for people with dementia and their caregivers, which Alzheimer’s Disease International is trying to solve through Dementia Care skills training modules, supported by Master Trainers from Alzheimer’s Disease Association Singapore and other ADI members. The program gives local carers tools with which to provide high quality care.

“If you ask me about challenges, these countries are in a very different place in terms of where they are, and what they need varies. But one thing for sure is they need a pool of talent or a pool of experts or trainers.”

Suharya’s mother has been the inspiration behind her work. She was diagnosed with dementia in 2009, but now Suharya knows that her mother was displaying typical symptoms long before that without anyone realizing it. It caused a lot of tension between Suharya and her mother. “We had our arguments in the past because I did not know what’s going on in her brain.”

It drove her to look for work opportunities abroad, so she wouldn’t have to spend time at home. She ended up working as a journalist, and later as a public health communication consultant for organizations like the World Bank, WHO and UNICEF. She says, “I did everything that would take me away from Indonesia.”

One day, she received a call from her father, informing Suharya of her mother’s diagnosis. In 2012, she decided to come back home after 15 years of living abroad, gathered together her friends and asked them for help in setting up Alzheimer Indonesia, which launched in 2013, on her mother’s birthday. Campaigning to raise awareness of the early symptoms of Alzheimer’s has remained a prominent part of her work.

Suharya’s mother passed away six months ago, but her legacy continues in her work. “If not for my mom, I wouldn’t be here. It’s a thank you to her. Because of my experience, I feel like I can activate people’s highest potential, because my potentials were activated through my mom and inspired through the journey of caring for her with the support of my dad and siblings.”

In four years, Alzheimer Indonesia has grown in size and stature. This has included a comic book launch, film festival and choir concert being some of the highlights. There are now support groups in 21 cities in Indonesia, a WhatsApp support group and more than 1,000 volunteers. “Everything I dreamed of four years ago,” remarks Suharya.

The newest campaign, called “Love Your Parents,” wants to remind young people to be understanding toward the struggles their parents with dementia might have, to respect their parents and spend quality time with them.

“You cannot raise your voice to a person with dementia. You cannot make the same mistakes that I did. You cannot be angry because you’re accompanying your parents to a bank, and they don’t know where their ATM card is or how to use the telephone.”

Suharya describes herself as a big believer in collaboration and partnerships. As the session progresses, she hopes to see some of the discussion and initial plans held during the session realizing themselves in the future. She says, “I’m expecting a concrete collaboration that works as a platform to people who share similar goals – whatever they are good at. I like to connect people, and I like to make things happen."


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Innovations in Dementia Care - Reducing the Stigma
Innovations in Dementia Care - Reducing the Stigma
Salzburg Global Seminar 

Stigma is difficult to define, but you know it when you feel it. That was the message which started the second day of the Salzburg Global session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.

The message was delivered by William Hu, assistant professor of neurology at Emory University, as he moderated a discussion which explored how stigma around dementia varies from country to country and the different ways it is being addressed.

Raising awareness of dementia and improving education is not just about providing communities with a greater understanding. It’s also about changing the self-perception of those living with dementia.

Chris Roberts, a Dementia Friends Champion and Ambassador for the Alzheimer’s Society, said parts of the media had accentuated the stigma around dementia, and that society had reached a point where people failed to realize there was a beginning and a middle to every illness.

Roberts, who has a diagnosis of mixed dementia, vascular damage and Alzheimer’s, suggested people should stop using the word “dementia” and start referring to the different conditions by their own names.

Participants considered the different ways in which the stigma around dementia is reinforced. They reflected on the misuse of language and the patient and carer roles which are often assigned at the point of diagnosis.

One participant said stigma should be challenged from the ground up through education. This point was echoed by another participant who called for a change in curriculum that would provide more opportunities for students to interact with people living with dementia.

Participants shared experiences between themselves throughout the session. The group heard how one man living with dementia in Nigeria was unable to openly share his experience, despite wanting to. The people around him would not let him. The stigma was so strong they feared they would be accused of witchcraft.

To reduce the stigma, a new behavioral change will have to be generated. In Indonesia, the media has played an important role in this regard. A series of multimedia campaigns have increased interest in the subject and has led to requests for more people with dementia to tell their stories.

Advocates and people living with dementia can continue to breakdown barriers by engaging with people from their own countries and communities.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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Innovations in Dementia Care - Making a Difference in People's Lives
Albert Mulley, Veronique Roger, and John Lotherington set the scene on the first day of the session
Innovations in Dementia Care - Making a Difference in People's Lives
Salzburg Global Seminar 

Policymakers, clinicians, carers and service users from around the world have convened at Schloss Leopoldskron, Salzburg, to tackle one of the most serious and growing health challenges for health care.

Around 40 participants from 14 countries met on Tuesday afternoon for the start of the Salzburg Global session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities.
This session is part of Salzburg Global’s multi-year series Health and Health Care Innovation in the 21st Century. It is being held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice, and the Mayo Clinic.

For the next few days, participants will discuss the challenges people living with dementia experience and explore ways in which to better support them and their families.

To set the scene, the six-day program began yesterday with a panel discussion involving session co-chairs Albert Mulley and Veronique Roger.

Roger, director of the Mayo Clinic Center for the Science of Health Care Delivery, described Salzburg Global as a “unique setting” to reflect on “really important critical health issues.” She suggested global well-being would require more than the input of the health care system. This view was echoed by Mulley, managing director for global health care delivery science at The Dartmouth Institute, when he suggested there were other factors to consider.

Mulley said there was a false assumption that the more money spent and the more done on health care interventions would lead to better health and well-being for all. Mulley said social determinants, behavior and genes provided a far greater contribution.

Taking these views into account, participants began to consider questions they would like answered during this week’s program. This included: What do we mean by a dementia-friendly community?

While the meaning and term continue to be debated among participants, several did agree any chance of making progress in this field was dependent on political will and that people living with dementia also had to be involved in the process.

In many countries, there is still much to be done in building awareness around dementia and helping people understand the seriousness of the issue. Cultural differences have to be taken into account when reviewing what actions might be effective in different regions.

These talking points, and more, will continue to be analyzed in the days ahead as the session continues.


The session, Changing Minds: Innovations in Dementia Care and Dementia-Friendly Communities, is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with The Dartmouth Institute for Health Policy & Clinical Practice and The Mayo Clinic. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

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