National Plan to Address Alzheimer’s Disease: 2021 Update

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

The ninth update to the National Plan to Address Alzheimer’s Disease was posted by the U.S. Department of Health and Human Services on Monday, December 27, 2021.  This document is 117 pages in length.

“On January 4, 2011, the National Alzheimer’s Project Act (NAPA) (Public Law 111-375) was signed into law. The Act defines “Alzheimer’s” as Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD) and requires the Secretary of the U.S. Department of Health and Human Services (HHS) to establish the National Alzheimer’s Project to:

• Create and maintain an integrated National Plan to overcome Alzheimer’s disease;

• Coordinate Alzheimer’s disease research and services across all federal agencies;

• Accelerate the development of treatments that would prevent, halt, or reverse the course of Alzheimer’s disease;

• Improve early diagnosis and coordination of care and treatment of Alzheimer’s disease;

• Decrease disparities in Alzheimer’s disease for racial and ethnic minority populations that are at higher risk for Alzheimer’s disease; and,

• Coordinate with international bodies to fight Alzheimer’s disease globally.

The law also establishes the Advisory Council on Alzheimer’s Research, Care, and Services (Advisory Council) and requires the Secretary of HHS, in collaboration with the Advisory Council, to create and maintain a National Plan to overcome AD/ADRD.

NAPA offers a historic opportunity to address the many challenges facing people with AD/ADRD and their families. Given the great demographic shifts that will occur over the next 30 years, including the doubling of the population of older adults, the success of this effort is of great importance to people with AD/ADRD and their family members, caregivers, public policy makers, and health and social service providers.”

This ninth update includes an additional goal of accelerating action to promote healthy aging and reduce risk factors for ADRD. Figure 1 within the document (and shown below) provides an overall view of the six (6) goals:

“AD/ADRD is a major public health issue and will increasingly affect the health and well-being of the population. Unless the diseases can be effectively treated or prevented, the number of Americans with AD/ADRD will increase significantly in the next 2 decades as the population ages. The Bureau of the Census estimates that the number of people age 65 and older in the United States will almost double, to 88 million by 2050. The prevalence of people with AD/ADRD doubles for every 5-year interval beyond age 65. Without a preventive treatment or cure, the significant growth in the population over age 85 that is estimated to occur between 2015 and 2050 (from 6.3 million to 19 million) suggests a substantial increase in the number of people with AD/ADRD.

Significant emotional, physical, and financial stress is placed on individuals with AD/ADRD and their family members. Unpaid caregivers, often family members and friends, provide the majority of care for people with AD/ADRD in the community. Unpaid caregivers frequently do not identify themselves as such; they may be a wife, daughter, husband, parent, son, or friend helping a person whom they care about. However, the intensive support required for a person with AD/ADRD can negatively impact the caregiver’s emotional and physical health and well-being and their ability to work. Unpaid caregivers often report symptoms of depression and anxiety, and they have poorer health outcomes than their peers who do not provide such care.

Dementia care costs are significant and often a burden to families and others providing unpaid care. Recent estimates from one nationally representative study found that paid and unpaid care costs for people older than age 70 with dementia in the United States in 2010 were between $159 billion and $215 billion. These figures include direct medical expenditures, costs for long-term services and supports (LTSS) including institutional and home and community-based services (HCBS), and two different estimates of the value of unpaid care provided by family members and friends. These costs could rise dramatically with the increase in the numbers of older adults in coming decades. Care costs per person with dementia in 2010 ranged from $75,000 to $83,000 depending on how unpaid care costs were estimated. These national dementia care costs are comparable to, if not greater than, those for heart disease and cancer.”

The document contains a great deal of invaluable information. Please share this plan with your team and colleagues.