Growing and implementing a coordinated public health response to address Alzheimer's Disease, related dementias and healthy aging in Vermont - Through its BOLD core capacity grant, Vermont (VT) has been increasing its infrastructure to address the daunting challenge of addressing dementia and co-morbidities. In 2019, 20% of Vermonters were 65 years or older. VT, one of the most rural states, has the largest older adult population living in rural areas, approximately 65% of those 65+. Rural residents have lower healthcare utilization for primary care and specialty care, compared to people living in urban areas, despite having health needs including higher prevalence of hypertension, diabetes, poor oral health, and smoking. In VT, 28% of residents 65+ have 3-4 chronic conditions and 38% have 5+ conditions, making chronic disease prevention, dementia awareness and risk reduction, and clinical co-morbidity management priority areas. This CDC funding opportunity, RFA-DP23-0010, will enable VT’s Alzheimer’s Disease and Healthy Aging Program (VADHAP) to implement its Action Plan on Alzheimer’s Disease, Related Dementias (ADRD) and Healthy Aging; expand the diversity of its Coalition; increase awareness of ADRD and advance equity in aging well; destigmatize dementia including for caregivers; and create a brain health over the lifespan data and dissemination plan with partners. The Vermont Department of Health’s (VDH) commitment to addressing ADRD is in collaboration with partners including the Department of Disabilities, Aging and Independent Living (DAIL), the Alzheimer’s Association – VT, and the state’s Coalition consisting of 4 workgroups (Governor’s Commission on ADRD, Hub and Spoke ADRD, Chronic Disease and Brain Health, and the Alzheimer’s Disease and Healthy Aging). These workgroups’ agendas are coordinated by VADHAP, DAIL, and Alzheimer’s Association – VT. VADHAP’s proposed Staffing Plan, Evaluation and Performance Management Plan, and Workplan demonstrate capacity for carrying out the HBI Road Map and the Road Map for Indian Country domains and strategies as a state health priority. VADHAP will accomplish the three prevention tiers and performance outcomes for Component 2 grantees. VADHAP is seeking to bring ageism into the fold of VDH’s health equity efforts in the state, which is aging faster than the nation. Considering ongoing findings on the increased dementia risk of long COVID including among the neurodiverse population, VADHAP is exploring with its chronic disease division ways to increase coordinated care for those impacted. ADRD is one of the most under-recognized public health challenges. This funding will expand VT’s capacity for effective efforts including amplified healthy aging surveillance with DAIL; coordination with other state plans to support ADRD and brain health; development of a Dementia Specialist network to improve clinical-community linkages including with CHWs, specialists and allied health; robust evaluation planning with its Coalition; and a new shared position with the Hypertension and/or Arthritis Programs. The Hub and Spoke ADRD Workgroup will implement its pilot deploying UCLA’s Dementia Care Model and develop a more dementia capable clinical workforce. Other key components include Office of Local Health’s advancing Dementia Friendly Communities and VADHAP increasing understanding of the relationship of chronic disease and brain health as central to healthy aging. VADHAP’S approach is data informed and equity based. Surveys, needs assessments and listening sessions in addition to scientific developments will inform and update VADHAP’s collaborative efforts. VADHAP and Coalition partners will implement 19 HBI roadmap actions included in the Action Plan including those addressing SDOH to advance health equity goals. VADHAP will achieve outcomes associated with increasing earlier detection and diagnosis, reducing dementia risk and improving caregiver support, and reducing preventable hospitalizations among all Vermonters with dementia. These achievements will be demonstrated by evaluation, data presentation and publication.
