This study analyzes the textual characteristics of China's national-level dementia prevention and treatment policies during the "14th Five-Year Plan" period, reveals the distribution patterns and intrinsic relationships among policy instruments, stakeholders, and policy intensity, and provides a basis for optimizing and improving the policy system.

National-level policy texts related to dementia prevention and treatment issued from 2021 to 2025 were retrieved; a three-dimensional analytical framework comprising "policy tools-stakeholders-policy intensity" was constructed; content analysis was employed for coding; and coding reliability was tested using Cohen’s Kappa coefficient. MAXQDA 2022 was used to conduct quantitative statistical analysis across three dimensions: policy instrument types (supply-oriented, environment-oriented, and demand-oriented), stakeholders (six categories including government departments, medical institutions, and healthcare personnel), and policy intensity (1-5 points).

A total of 15 policy texts related to dementia prevention and treatment were included, yielding 276 policy instrument codes, with good coding reliability (the three-dimensional kappa coefficients are 0.85, 0.82, and 0.82, respectively). Unidimensional analysis showed that environmental-oriented tools have the highest proportion (122 codes, 44.20%), followed by supply-oriented tools (113 codes, 40.94%), and demand-oriented tools have a significantly lower proportion (41 codes, 14.86%); policy attention was focused on medical institutions (73 codes, 30.80%) and government departments (71 codes, 29.96%), while social capital (18 codes, 7.59%) and health personnel (16 codes, 6.75%) had lower levels of attention; the average policy intensity was relatively low (2.80 points), manifested by the coexistence of six joint documents issued by three or more ministries and five separate documents issued by each ministry, and the lack of policies issued by the dual ministries and commissions. Cross analysis showed that policy tools were unevenly distributed among different entities, with medical institutions (73 codes) and government departments (71 codes) undertaking the most, while health personnel (16 codes) and social capital (18 codes) undertaking the least; the average strength of the three types of tools was 2.55 points for demand type, 2.34 points for environmental type, and 2.20 points for supply type. The price service strength in the demand-oriented tools was the highest (4.50 points), but only 4 codes were available. In 3D analysis, environmental tools had the highest total strength (306 points), while demand based tools had the lowest (116 points); medical institutions (139 points) and government departments (122 points) ranked first in terms of overall strength, while health personnel had the lowest (30 points).

The policy system for the prevention and treatment of dementia in China presents structural characteristics of "intensive planning, supply start-up, insufficient demand and weak strength". The allocation of policy tools focuses more on supply, with insufficient attention to demand. The executing entities are concentrated in medical institutions and government departments, and the overall policy intensity is low and lacks continuity. Continuous optimization is needed in terms of tool balance, subject coverage, and intensity continuity.