Implementing BOLD Public Health Programs to Address ADRD in South Carolina - South Carolina (SC) has an Alzheimer’s crisis. SC has one of the fastest-growing population of older adults in the country, with 19% of the total population being elderly. There has been a 166% increase in Alzheimer’s disease deaths in SC since 2000, well above the 145% national average. Alzheimer’s disease is currently the 7th leading cause of death in SC. Despite this data and the obvious need for care, there are only 66 geriatricians, those specializing in the medical needs of seniors, working in SC. A 336% increase would be needed to meet the population needs by 2050. Caregiver burden is also a problem in SC, with an estimated 197,000 caregivers providing unpaid care at a value of over $4.3 billon. When it comes to Medicaid costs, SC spends $652 million on the care of people with Alzheimer’s. The average per-person Medicaid cost for seniors with dementia is 23 times higher than average spending for seniors without dementia. There are many factors that contribute to the risk of cognitive decline, including hypertension, diabetes, obesity, and smoking. SC is at an increased risk for these chronic diseases due to its aging population and being in the “Stroke Belt”, a set of southeastern states with higher burden of stroke and cardiovascular disease compared to other US regions. Many South Carolinians are not aware of the link between chronic disease and cognitive decline, and don’t know the appropriate strategies to best preserve cognitive function and reduce risk for impairment. The SC Department of Health and Environmental Control (DHEC) Division of Injury and Substance Abuse Prevention (DISAP), along with partners, is positioned to lead the BOLD Public Health Program to Address Alzheimer’s Disease and Related Dementias (ADRD) efforts in SC. DHEC will implement a public health approach that builds upon work and partnerships already established through the previous CDC Cooperative Agreement, which provided funds to develop the 2023-2028 South Carolina Statewide Plan to Address ADRD. DHEC’s BOLD activities include maintaining and expanding the ADRD statewide coalition, implementation of activities from the statewide ADRD strategic plan, educating coalition members, partners, providers, and the general public on ADRD topics, and utilizing a variety of diverse data sources to improve sustainability and identify community-clinical linkages. All efforts will use policy, systems and environmental interventions and a public health approach to address short-term, intermediate, and long-term outcomes by the end of the project period that include but are not limited to: 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, and; Increased number of community-clinical linkages among health care systems and existing services, public health agencies, and community-based organizations.