Alzheimer’s and related dementias represent a growing public health crisis. Prevalence of Alzheimer’s is projected to reach nearly 14 million by 2050, with costs totaling more than $1 trillion. It disproportionately affects African Americans, Hispanics, American Indian/Alaska Natives, and women. There is no known treatment or cure. But, estimates are that more than one-third of the cases are due to modifiable risk factors, such as hypertension, diabetes, obesity, smoking, and a sedentary lifestyle. Many of these risk factors are more prevalent in the groups mentioned above, which may explain the disproportionate impact. A growing body of knowledge about dementia risk combined with a rapidly aging population create a scenario of promise and urgency: it is time for nationwide, systemic public health action on dementia risk reduction.
The Alzheimer’s Association proposes to lead, in collaboration with the CDC and national partners—Wake Forest University, the Association of State and Territorial Health Officials, and the National Association of County and City Health Officials—a Center of Excellence on Dementia Risk Reduction to support public health agencies in implementing the Healthy Brain Initiative’s Road Map. The purpose of the project is to (1) translate the science on modifiable risk factors into actionable public health interventions, messaging, and campaigns, including actions specifically for higher-risk communities; (2) make these approaches publicly available; (3) work to disseminate to, and encourage uptake by, public health agencies; and (4) continuously update and improve the approaches and best practices through feedback and evaluation.
Consistent with the CDC’s logic model, the main outcomes are to (1) increase access to dementia risk reduction tools and materials for use by state, local, and tribal public health agencies; and (2) increase use of those best practices and proven strategies.
These outcomes will be achieved via a 6-step, annually repeating cycle of activities that allows for regular quality improvement. Step 1. The evidence on dementia risk factors will be reviewed and synthesized to produce a prioritized list of risk factors most ripe for public health action. Step 2. A Public Health Roundtable—consisting of public health experts, public health officials, and individuals representing diverse communities—will be convened to translate the science into interventions and activities that public health agencies can implement. Step 3. An Innovation Lab will use the findings from Step 2 to create best practices, interventions, tools, and materials for use by state, local, and tribal public health agencies. Step 4. All materials will be uploaded to an online Clearinghouse. Step 5. The Association’s 77 chapters and the national partners will lead dissemination efforts to encourage public health agencies to take action to reduce the risk of dementia. Step 6. Regular feedback and evaluation on the interventions and best practices—as well as dissemination tactics—will be used by another Public Health Roundtable (Step 2), followed by the subsequent steps, to create a continuous loop of ongoing quality improvement.
The Alzheimer’s Association is uniquely positioned to undertake this project. Our global scientific leadership on dementia, including research on risk reduction, is unmatched. We have a 15-year history of working on brain health in the public health arena, including co-authoring the Road Map and creating materials for use by public health agencies. Our nationwide network of 77 chapters has unparalleled experience engaging public health officials across the country on the issues of cognitive health and dementia. And, we have a strong track record in developing and working with national stakeholders to advance a shared vision of strengthening the public health infrastructure to address cognitive health.