Early detection — a core function of public health — is essential to providing access to information, care and support to people living with Alzheimer’s and other dementia as well as their caregivers. Both the general public and health care providers must know the early warning signs of cognitive impairment, feel empowered to discuss cognitive concerns, and understand what steps to take next.

To help the public health community increase early detection of cognitive impairment, the Alzheimer’s Association and the Centers for Disease Control and Prevention (CDC) developed this topic-specific issue map — Advancing Early Detection. It offers compelling data on the topic, a primer explaining the need for action, suggests related HBI Road Map actions, and provides case studies to demonstrate successful implementation.

Learn how public health can advance early detection and diagnosis:

For the public

For early detection to occur, individuals must feel comfortable discussing concerns about their thinking and memory with their health care providers. This requires addressing barriers that often deter such converastions from happening. Barriers include minimal understanding of the warning signs of cognitive impairment, misperceptions about Alzheimer’s and other dementias, and fear of upsetting family members with concerns about possible cognitive impairment.

Primed for implementation: HBI Road Map

Action E-1 — Educate the public about brain health and cognitive aging, changes that should be discussed with a health professional, and benefits of early detection and diagnosis.

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Public health can educate their communities about cognitive health and empower them to take steps toward healthy aging. By sharing accurate and credible information, the public health community can:

  • Raise awareness about cognitive health and changes in thinking or memory that merit a conversation with a health care professional.
  • Shift mindsets and normalize discussions about cognitive health in the routine delivery of health care to support early detection.
  • Emphasize the many advantages to receiving a formal diagnosis, including access to treatments that help with symptoms, time to build a care team, and the opportunity to specify care and legal plans for the future.
  • Normalize discussions about healthy behaviors that may help reduce the risk of cognitive decline.
  • Improve access to available information, care planning, and community services to support physical and behavioral health as well as social, legal, financial and spiritual needs.
  • Reduce stigmas and myths surrounding the disease.

The earlier dementia is diagnosed, the sooner care can be provided. The advancement in recognizing biomarkers for Alzheimer's disease, is making it possible to detect Alzheimer's and provide an accurate diagnosis earlier than at any other time in history. As trusted sources of health information in their communities, public health leaders can educate the general public about cognitive health, the benefits of early detection, and when to discuss concerns with a health care provider.

State-specific action you can take

Communities are taking public health action against Alzheimer’s and other dementias. Find out how the disease impacts your state and what you can do to make Alzheimer's the next public health success story.

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For health care providers

Health care providers must be educated on timely detection and accurate diagnosis of Alzheimer’s and other dementias. Early diagnosis of Alzheimer's provides a number of important benefits to diagnosed individuals, their caregivers and loved ones, health systems, as well as society as a whole including:

Primed for implementation: HBI Road Map

Action W-5 — Strengthen the competencies of professionals who deliver health care and other care services to people with dementia through interprofessional training and other strategies.

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  • Improved access to medical and support services.
  • Explanation about the changes seen in the person with dementia.
  • Opportunity to make legal, financial and care plans while the affected individual is still capable.
  • Modifications to management of co-morbidities, taking into account potential self-care challenges.
  • Potential reduction in health care costs by delaying placement in a nursing home.​​
While the benefits of early detection are numerous and well-established, clinicians face obstacles hindering their ability to detect and diagnose dementia as early as possible. These barriers include: low recognition of the signs of cognitive impairment,
limited education or training on dementia care, concerns about stigma and the usefulness of an early diagnosis, confusion of cognitive impairment with conditions that may mimic dementia (including delirium, certain vitamin deficiencies and depression), lack of time, and difficulty talking about dementia or disclosing a diagnosis.


Health care providers often turn to public health agencies for help understanding the latest research, best practices, and emerging evidence on a number of health topics — including cognitive impairment and dementia. Public health officials can ensure that health care providers stay up-to-date with necessary education and training needed to properly assess cognitive impairment and compassionately disclose a diagnosis. Important areas for education include:

  • Recognition that Alzheimer’s and other dementias are often under-diagnosed.
  • Importance of and opportunities for early detection, diagnosis, documentation of diagnosis, and care of dementia.
  • Tools and resources available to help providers detect and diagnose cognitive impairment — these include the Medicare Annual Wellness Visit’s cognitive assessment benefit, reimbursement for comprehensive care planning (via the 99483 billing code), and availability of community services and supports after a diagnosis.
  • Thorough understanding of the need to monitor cognitive health among high risk populations similar to monitoring of other chronic conditions in high-risk cases.
  • Availability of resources to help detect and diagnose cognitive impairment as early as possible. Resources include:
  • Effective strategies to convey detection, diagnosis and resource referral information in ways that are culturally-appropriate, candid, clear and compassionate for different populations
  • The importance of accessing support services to effectively cope with the emotional toll that disclosing dementia diagnoses can have on health care professionals themselves.

Public health professionals also need access to sound and credible information about dementia, cognitive decline, and caregiving so that they are well- informed themselves and can communicate effectively and intelligently with other health care providers and payers. Geriatric Geriatrics Workforce Enhancement Programs, academic institutions, clinical practices and caregiver organizations can also help enhance health care providers’ knowledge and abilities on dementia through their own educational initiatives — credentialing, accreditation and licensure. A combination of continuing education, practical tools and resources, and community-clinical linkages can shift standards of practice and cultural norms.

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State successes: Educating health care providers in Hawaii and California

The Hawaii Director of Health sent a “Dear Colleague” letter to physicians encouraging early detection and diagnosis, including through the use of the Medicare Annual Wellness Visit benefit. Read the letter to learn more.

The California Department of Public Health (CDPH) created the Assessment of Cognitive Complaints for for Alzheimer’s Disease (ACCT-AD) to provide primary care providers with the tools and training necessary to recognize normal cognition, diagnose Alzheimer’s disease, and identify other cognitive problems requiring speciality referral. CDPH promotes the toolkit to providers statewide, including webinars on the importance of the toolkit and what it aims to accomplish.

State-specific action you can take

Communities are taking public health action against Alzheimer’s and other dementias. Find out how the disease impacts your state and what you can do to make Alzheimer's the next public health success story.

Learn More

Featured Resources

Alzheimer's Association & Centers for Disease Control and Prevention Advancing Early Detection - Healthy Brain Initiative Issue Map
Department of Health and Human Services alzheimers.gov

 
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AL Department of Public Health Alabama Department of Public Health had one of its divisions, Alabama Public Health Training Network, conduct a webcast for public health professionals about Alzheimer’s basics, with a free CEU available for state employees. Almost 200 people participated, and the recorded training is posted on YouTube.
AZ Banner Alzheimer's Institute The Banner Native American Outreach program increases awareness of Alzheimer's and other dementias among Arizona's American Indian communities, and works to establish better connections among tribal health organizations and urban Indian communities.
AZ Department of Health Services Arizona Department of Health Services and partners developed educational fact sheets about dementia, tailored to racially and ethnically diverse populations (via NACDD grant). The department also added information about Alzheimer’s and dementia caregiving to its website
AZ Maricopa County Public Health Department Maricopa County Public Health Dept.—with the regional chapter of the National Black Nurses Association, Banner Health Institute, and potentially other organizations—held a community educational event that raised African Americans’ awareness of Alzheimer’s, dementia, and other cognitive health issues.
CA City of Santa Clara Assessed where more resources are needed to assist in the early detection and diagnosis of individuals with dementia by mapping where people with dementia were "entering" the system (e.g., hospitals, aging services).
CA Los Angeles County Department. of Public Health Los Angeles County Department of Public Health—with the regional chapter of the National Black Nurses Association and potentially other organizations—held a community educational event that raised African Americans’ awareness of Alzheimer’s, dementia and other cognitive health issues.
FL Florida Department of Health Enhanced knowledge of cognitive decline, Alzheimer’s and other dementias, caregiving, and community resources at the Symposium through sessions for caregivers and the general public.
FL City of Miami Developing transit ads to educate about early warning signs and to promote early detection and diagnosis
GA City of Atlanta Created ministerial alliance on Alzheimer’s and other dementias to work with state government to promote awareness in the African-American community through faith-based organizations.
GA City of Atlanta Developing billboard campaign to promote public awareness of dementia and an 800-number for more information/help.
HI Department of Health Adapted existing print materials that encourage people to talk to health care professionals about memory problems, then disseminated the materials for placement in doctors’ offices.
KS Kansas Department of Health and Environment Increased public awareness of risk reduction messages to enhance early detection and reduce stigma via a partnership with the Kansas State Extension Office; trained almost 50 Extension Officers to educate Kansans about Alzheimer’s and brain health in counties across the state.
LA East New Orleans Health District East New Orleans Health District--—with the regional chapter of the National Black Nurses Association and potentially other organizations—held a community educational event that raised African Americans’ awareness of Alzheimer’s, dementia, and other cognitive health issues.
MA Department of Public Health Massachusetts Department of Public Health—with the regional chapter of the National Black Nurses Association and potentially other organizations—held a community educational event that raised African Americans’ awareness of Alzheimer’s, dementia, and other cognitive health issues.
MD Maryland Department of Health The Department of Health promoted a cognitive decline infographic (from BRFSS data) and recorded webinar in its Chronic Disease Connections newsletter in July 2017.
MD Department of Health and Mental Hygiene Maryland Department of Health and Mental Hygiene—with the regional chapter of the National Black Nurses Association and potentially other organizations—held a community educational event that raised African Americans’ awareness of Alzheimer’s, dementia, and other cognitive health issues.
ME Bangor Public Health Department Bangor Public Health Department distributed hundreds of ‘Know the 10 Signs’ brochures throughout the region to enhance public understanding of the early warning signs of dementia, including Alzheimer’s, and the value of early detection.
ME Department of Health and Human Services Developed GLBT-inclusive messaging for public awareness campaigns.
ME Kennebunkport Public Health Office Kennebunkport Public Health Office nurses are partnering with their local Alzheimer’s Association chapter to host a series of talks on Alzheimer’s for public health staff and community members.
ME Maine Public Health Association Maine Public Health Association devoted an issue of its e-newsletter to raising awareness about Alzheimer’s and other dementias.
MN Department of Health With legislative support, Minnesota Department of Health created new program focused on providing outreach and dementia education to African-Americans, African-born residents, and Asian and Hispanic populations.
MO Missouri Department of Health and Social Services Enhanced public awareness of cognitive health and dementia among African Americans in the southeast region of Missouri by conducting a multi-faceted social marketing campaign that provides culturally appropriate messaging and information on risks, early diagnosis, treatment, and community resources.
MO Missouri Department of Health and Social Services Promoted cognitive assessments and early diagnosis in partnership with Washington University and the existing Community Health Worker Advisory Body through incorporation of these topics into existing community health worker programs for diabetes, cardiovascular health, and women’s health.
NJ New Jersey Department of Health Department of Health, Office of Minority and Multicultural Health partnered with the Alzheimer's Association to conduct a brain health event in conjunction with African-American Brain Health Initiative (AABHI) and Rutgers University-Newark. AABHI promoted healthy aging among older African Americans at the Newark Classic Car Show (April 2017) by teaching older men about brain health, potential ways to reduce the risk of cognitive decline, and how to participate in aging research at RU-Newark.
NM New Mexico Department of Health Educated the public about ways to protect brain health by developing three PSAs based on the Alzheimer’s Association’s 10 Ways to Love Your Brain campaign; PSAs began airing on local TV station in fall 2017 and have been adapted for other media markets.
NM New Mexico Department of Health Improved support for caregivers of people living with dementia by co-marketing chronic disease selfmanagement courses and caregiving education programs; initial outreach resulted in more than 150 caregiver-participants.
NV Southern Nevada Health District The Southern Nevada Health District with the regional chapter of the National Black Nurses Association, and potentially other organizations to host a community educational event that raised African Americans’ awareness of Alzheimer’s, dementia, and other cognitive health issues.
OR Aging and Disability Resource Center (ADRC) of Oregon To promote early detection of Alzheimer’s disease among Hispanic populations, the Aging and Disability Resource Center (ADRC) of Oregon adapted an English-language fotonovela -- an educational tool with photos and a story narrative -- for Spanish-language communities. Involvement of promotoras enhanced cultural relevance. The Alzheimer's Association, Oregon Chapter, the Oregon Health Authority, and many other partners now promote and distribute the fotonovela to Spanish-speaking communities, in part through public health networks.
OR Oregon Health Authority Aging and Disability Resource Connection of Oregon published ¡Unidos Podemos! Enfrentando la pérdida de memoria en familia, a fotonovela for Spanish-speaking community members on caring for loved ones with Alzheimer’s disease. The Oregon Department of Human Services, Alzheimer's Association Oregon Chapter, and Oregon Health Authority now promote and distribute the fotonovela to Spanish-speaking communities and public health networks.
OR Tribal Health Agencies Tribal health agencies added a session on caregiving for people with Alzheimer’s and other dementias in their annual caregiver summit.
PR Department of Health Puerto Rico Department of Health leads a partnership to implement the Commonwealth’s state Alzheimer’s plan by organizing Un Café por el Alzheimer. Through in-person and social media platforms, the initiative facilitates conversations among experts and community members about cognitive health and Alzheimer’s disease (via an NACDD grant).
SC Department of Health and Environmental Control South Carolina Department of Health and Environmental Control worked with the Alzheimer’s Association South Carolina Chapter to distribute 48,000 of the association’s Know the 10 Signs brochures through its regional offices to raise awareness, especially among African Americans.
SC Department of Health and Environmental Control South Carolina Department of Health and Environmental Control, Division of Healthy Aging, included an article titled “November is Alzheimer’s Disease Awareness Month” in its monthly newsletter. The article provides basic information about Alzheimer’s disease.
SC Department of Health and Environmental Control Worked with leaders in underserved communities to conduct culturally appropriate workshops on the differences between normal, age-related cognitive changes and the warning signs of dementia or other health conditions.
TN Tennessee Department of Health Educated public health professionals about cognitive health, health indicators, diagnosis, and community resources via an issue brief developed from original data analyses and conducted a live training webinar to discuss findings and implications for public health practice.
TX Dallas County Public Health Department Adapted and promoted a public service announcement to educate the public about brain health and ways to protect cognition.
TX Harris County Public Health Department Adapted and promoted a public service announcement to educate the public about brain health and ways to protect cognition.
TX City of San Antonio Published a column on Alzheimer’s disease in the local Spanish-language paper, with an emphasis on increasing awareness and promoting early detection and diagnosis.
VA Virginia Department of Health Virginia Department of Health added weblinks to the department's website on Alzheimer's, dementia, and brain health
VA Virginia Department of Health Virginia Department of Health, Office of Health Equity arranged for the Greater Richmond Alzheimer's Association Chapter to brief the Virginia Partners in Prayer & Prevention (Virginia P3, an evolution of the Congregations for Million Hearts program) program partners. As a result, P3 program invited the Alzheimer's Association to participate in and provide information at tables at P3 Community Health Champions' Health and Wellness events across the state later that year.
VA Petersburg/Crater Health District The district—with the regional chapter of the National Black Nurses Association, Virginia Commonwealth University, and potentially other organizations—held a community educational event that raised African Americans’ awareness of Alzheimer’s, dementia, and other cognitive health issues.
WA Washington State Department of Health Educated African Americans about brain health by partnering with the Center for MultiCultural Health in Seattle; the Center identified African American churches as promising venues to speak about brain health and distribute hand fans with culturally-appropriate messages that promote brain health.
WA State Department of Health With the National Asian Pacific Center on Aging, the Washington State Department of Health tested University of Pennsylvania media messages with Asian American adults who may have concerns about changes in their aging parents’ memory or cognition.
WI Wisconsin Department of Health Services Developed online training for family caregivers of people with Alzheimer’s disease or other dementia and provides a list of resources for caregivers
WI Wisconsin Department of Health Services Wisconsin Department of Health Services and a designated group of stakeholders, the University of Wisconsin Oshkosh (UWO), Center for Career Development and Employability Training (CCDET) is developing a series of free, online trainings related to dementia care for crisis responders, caregivers, healthcare providers, family and community members, and other professionals. A Spanish-language version is available.

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