With the increasing burden of dementia as a prevalent health concern, national-level policy responses in the form of dementia management programs have become crucial. Dementia management involves multiple stakeholders, with the dementia management system representing the organizational structure responsible for implementing these programs. This research aims to examine the history and role evolution of the dementia management system, which includes National Institute of Dementia, Regional Dementia Centers, and Dementia Reasurance Centers. The roles of the dementia management system have been articulated in various policies, such as the Elderly Welfare Act, Dementia Management Act, Dementia Elderly 10-Year Plan, and the 1st to 4th National Dementia Plans. The role of the National Institute for Dementia began with a focus on research and statistical management, while the role of the Regional Dementia Center started with an emphasis on education and technical support. However, both are undergoing a transformation in their roles, moving towards strengthening policy support functions. The Dementia Reasurance Centers, initially focused on early detection program due to infrastructure limitations, have evolved to perform additional roles as nationwide infrastructure has been secured. These centers are now expanding their roles, and strengthening functions related to service coordination and integration.