New law signed aims to better target Alzheimer’s prevention, treatment

Despite the partial government shutdown, some wheels in Congress keep turning. Among them, the BOLD Act (Building Our Largest Dementia Infrastructure for Alzheimer’s) was signed into law on December 31.

The BOLD Act authorizes $100 million over five years to develop a public health approach for improving prevention, treatment and care for Alzheimer’s patients by creating a national public health infrastructure to combat the disease and preserve brain health.

It establishes Alzheimer’s Centers of Excellence with a focus on evidence-based interventions in Alzheimer’s disease. It also funds state and local public health departments to promote cognitive health, reduce risk, improve early detection and diagnosis, and better meet the needs of caregivers. The initiative includes provisions for educating public health officials, health professionals and the public on current Alzheimer’s and dementia information and research, including cognitive decline, brain health and health disparities.

The BOLD Act also will increase collection, analysis and timely reporting of data on cognitive decline and caregiving to inform future public health actions, according to the Alzheimer’s Impact Movement (AIM), the advocacy arm of the Alzheimer’s Association.

“Too often, Alzheimer’s and other dementias are viewed just as an aging issue, ignoring the public health consequences of a fatal disease that more than 5 million Americans are living with,” said Harry Johns, chief executive of the association and AIM. “The BOLD Infrastructure for Alzheimer’s Act will ensure communities across the country have access to resources to promote effective Alzheimer’s interventions and better cognitive health that can lead to improved health outcomes.”

The new law instructs HHS to identify and translate promising research findings into evidence-based programs for people with Alzheimer’s disease and related dementias and their caregivers. It also directs the agency to expand activities through public-private partnerships with state public health departments, Native American tribes, and other entities “to promote cognitive functioning, address cognitive impairment and unique aspects of Alzheimer’s disease, and help meet the needs of caregivers.”

Institutions, researchers and companies wishing to participate in the initiative must show how they will address evidence-based practice. This could include training state, local and tribal public health officials, supporting early detection and diagnosis, reducing the risk of potentially avoidable hospitalizations for people with Alzheimer’s and related dementias, reducing the risk of cognitive decline or impairment, supporting caregivers, supporting care planning and management. Addressing rural and underserved populations and addressing health disparities are key focal points.

“After decades of increasing investments in biomedical research for Alzheimer’s, we are ready for the next step: to translate research into practice,” said co-sponsor Sen. Susan Collins (R-ME) in a statement. “The BOLD Act takes a multi-pronged public health approach that will create a modern infrastructure for the prevention, treatment and care of Alzheimer’s and related dementias. BOLD brings us to the brink of a brighter day for Alzheimer’s.”

In addition to Collins, bill co-authors include Sens. Tim Kaine (D-VA), Catherine Cortez Masto (D-NV) and Shelley Moore Capito (R-WV). It was introduced in the House by Reps. Brett Guthrie (R-Ky.), Paul Tonko (D-N.Y.), Chris Smith (R-N.J.) and Maxine Waters (D-Calif.). It passed the Senate unanimously and through the House 361-3.

“Alzheimer’s prevention is crucial to combating this debilitating disease,” said Cortez Masto. “The number of Americans afflicted with this illness is growing at a staggering pace, and without intervention, as many as 16 million Americans could be living with the disease by 2050.”

Alzheimer’s is the most expensive disease in the country, with an estimated cost of $259 billion annually — including $175 billion in Medicare and Medicaid payments, according to the Alzheimer’s Association. It is the nation’s sixth leading cause of death.

Here are some resources for reporting in this story:

  • Check out the CDC’s Healthy Brain Initiative (HBI) and its Public Health Road Map. The HBI Road Map includes actions for state and local public health departments to promote cognitive functioning, address cognitive impairment and help meet caregivers’ needs. The BOLD Infrastructure for Alzheimer’s Act would increase implementation of the road map nationwide. This is the 2018-2023 roadmap. What is your state doing, or planning to do?

This AHCJ tip sheet offers more ideas on covering and understanding Alzheimer’s and related dementias.

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