BOLD Public Health Programs to Address Alzheimer's Disease and Related Dementias - The Texas Department of State Health Services (DSHS) is applying for Component 2 of this funding opportunity. Alzheimer’s disease (Alzheimer’s) is a multi-faceted progressive neurodegenerative condition impacted by age, genetics, and likely lifestyle and environmental factors. In 2020, approximately 400,000 Texans aged 65 and older were living with Alzheimer’s. In terms of absolute numbers, Texas ranks fourth in the nation in the number of Alzheimer’s cases and second in the number of Alzheimer’s deaths. In 2021, an estimated 14.3 percent of Texas adults aged 45 and older reported cognitive decline, an increase from 2019, when approximately 11.6 percent of the same subgroup reported cognitive decline. In the last several years (2020-2021), Alzheimer’s was one of the top ten leading causes of death each year, with an age-adjusted mortality rate of 44.6 per 100,000 individuals in Texas in 2020, an increase from 38.4 per 100,000 individuals in 2018. Some Texas populations reporting higher rates of cognitive decline than the state rate include Hispanic Americans (14.9 percent), rural residents (20.7 percent), and residents in public health regions 5 (East Texas, 17.9 percent) and 11 (South Texas, 17.8 percent). In Texas, approximately 1.1 million unpaid caregivers provided care to Texans with Alzheimer’s in 2021. This equates to an estimated 1.77 billion hours of unpaid care at a cost of approximately $25.9 billion per year. There is a shortage of dementia specialists across the country. Access to these health providers is particularly limited in rural populations. Sixty-three percent of primary care physicians (PCPs) in a small city or town and 71.0 percent of PCPs in a rural area reported a lack of specialists. The DSHS Alzheimer’s Disease Program (ADP) will use existing partnerships and its jurisdiction strategic plan to enhance and build statewide infrastructure and increase capacity to improve the response to Alzheimer’s disease and related dementias (ADRD) in Texas. ADP will use a public health approach based on the Healthy Brain Initiative, State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map. ADP will use evidence-based and targeted approaches to provide education to Texans with a focus on populations highly impacted by ADRD: East Texas, Hispanic Americans, and rural residents. DSHS will achieve the following outcomes by the end of the project period: • Increased number and variety of coalition members collaborating on and implementing sustainable ADRD activities informed by data. • Increased education opportunities for the general public, providers, and other professionals that provide information on ADRD topics, including primary, secondary, and tertiary prevention, and the needs of caregivers. • Increased availability and use of the Behavioral Risk Factor Surveillance System data and other data sources to inform, monitor, or improve ADRD activities. • Increased number of community-clinical linkages among health care systems and existing services, public health agencies, and community-based organizations. • Improved implementation of jurisdiction ADRD goals that are comprehensive across public health domains, ADRD topics, and prevention levels. • Increased awareness and understanding of ADRD topics among the general public, providers, and other professionals. • Increased sustainability of program activities.
