Alzheimer’s disease is the second leading cause of death in Los Angeles County, with nearly 4,000 deaths per year, accounting for 25% of all such deaths in California. Based on national and local trends data, these numbers are expected to rise in the next decade. For example, from 2008 to 2017, the Alzheimer’s disease mortality rate in the county increased by 71%, by far the largest increase of any disease during the time span. According to the Alzheimer’s Association, an estimated 166,500 Angelenos are living with this disease currently. By 2030, this number is estimated to increase by 67% to >278,000.
As is the case elsewhere, the impact of Alzheimer’s disease does not affect all communities equally in Los Angeles County, home to more than 10 million residents. For instance, the county’s most rural Service Planning Area (Antelope Valley) has an adjusted Alzheimer’s disease mortality rate of 70 per 100,000, far higher than the overall county rate of 38.7 per 100,000. Disparities in the burden of modifiable risk factors for this disease and for other related dementias, including obesity, diabetes, and untreated hypertension, were also significant in several subgroups across the region. Based on local surveillance data, African Americans and Latinos have the highest rates of diabetes (14.4% and 13.6%, respectively, as compared to whites, 8.8%); African Americans also have the highest rate of hypertension (35.9%, as compared to whites, 27.3%); and Native Hawaiians and Other Pacific Islanders have the highest rate of obesity (52%, as compared to whites, 21.9%).
The proposed project – Los Angeles County BOLD Initiative (LA BOLD) – intends to address this silent but burgeoning epidemic of Alzheimer's disease and related dementias in the county of Los Angeles by bringing together a diverse group of multi-sector key stakeholders (e.g., the two Area Agencies on Aging) to create a strategic plan and the capacity necessary to prevent and manage these cognitive disorders. Using the latest evidence, LA BOLD will lay the foundation for and put in place strategies that can target and improve the areas of risk reduction, early detection, and prevention and management of comorbidities related to these cognitive conditions.