A Reason to Hope

There has never been a more critical time to join the fight to end Alzheimer’s disease. More than 5 million Americans are living with Alzheimer’s and over 15 million Americans are providing unpaid care and support. Both of these numbers are expected to triple by 2050.

While the numbers are astounding, the Alzheimer’s Association and advocates, especially families impacted by the disease, have committed to offering personal insight into the positive impact of the Association’s family and research programs. The Association’s programs and services are provided at no cost to families and individuals living with Alzheimer’s.

Alzheimer’s has been viewed as an “aging issue”. It also has an effect on a community level and is, quite frankly, a public health issue. Alzheimer’s meets the three-point criteria for identifying a public health issue:

  1. the burden is large
  2. the impact is major
  3. there are ways to intervene

Alzheimer’s is the most expensive disease in our country, as costs now exceed a quarter of a trillion dollars per year. The costs of Alzheimer’s in 2017 were $259 Billion. The number of people living with Alzheimer’s is projected to triple to as many as 16 million in 2050, and the costs are expected to rise to $1.1 Trillion.

Due to the toll of caring for someone with Alzheimer’s, caregivers have more than $10 Billion in additional health care costs each year. Among people with dementia, one in every four hospitalizations is preventable. Alzheimer’s imposes a significant cost on federal and state budgets:

  • More than 2/3 of the health and long-term care costs of caring got those with Alzheimer’s are borne by Medicare and Medicaid.
  • Nearly one in every five dollars spent by Medicare is spent on people with Alzheimer’s and other dementias.

And, the impact is growing larger. By 2050, one in every three Medicare dollars will be spent on someone with Alzheimer’s and other dementias.

Public health officials can use the traditional tools and techniques of public health to improve the quality of life for those living with Alzheimer’s and to reduce the costs associated with it. Interventions include primary prevention, early detection and diagnosis, data collection, and access to quality care and services.

The Centers for Disease Control (CDC) leads the nation’s public health efforts and funds more public health activities at the state level. CDC’s Healthy Brain Initiative, launched in 2005, created the Public Health Road Map, which includes action items for public health departments to promote cognitive functioning, address cognitive impairment, and help meet the needs of caregivers. Congress can strengthen CDC’s efforts to combat Alzheimer;s disease by passing the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act.

The BOLD Alzheimer’s Act (S.2076/H.R.4256) establishes Alzheimer’s Centers of Excellence around the country to expand and promote innovative and effective Alzheimer’s interventions. It provides funding to state, local, and tribal public health departments to implement those interventions and to carry out the Public Health road Map, including promoting early detection and diagnosis, reducing risk, and preventing avoidable hospitalizations, while increasing the collection, analysis, and timely reporting of data on cognitive decline and care giving to inform future public health actions.

The BOLD Infrastructure for Alzheimer’s Act calls for applying the tools of public health to the Alzheimer’s crisis, and a crisis it is. There have been substantial changes in the patterns of care, better diagnostic tools, but essentially no progress toward a cure or even a way to slow the progress of the disease.

Also, no analog of the BOLD Act exists at the state level, but there is an omnibus bill now in the House (H.4116), which includes institution of the state Alzheimer’s Plan, which will assure resources are allocated to administer services, as well as education of health providers to ensure people with Alzheimer’s are diagnosed and care plans implemented.