Increasingly, communities around the country are taking a public health approach to address Alzheimer's, a pivotal and growing public health crisis that requires robust responses.
Why is Alzheimer's a public health issue?
Alzheimer's and other dementias have become a public health issue because:
- The burden is large.
- The impact is major.
- Interventions can make a difference.
Today, more than 6 million Americans are living with Alzheimer's, and in 2023, the cost of caring for them is $345 billion. This burden is only projected to grow. By 2050, nearly 13 million Americans could be living with Alzheimer's, with costs reaching nearly $1 trillion. Federal and state governments shoulder two-thirds of the cost of Alzheimer's through Medicaid and Medicare.
Nearly one quarter of all hospitalizations of people with dementia are preventable — at a cost to Medicare of nearly $4.7 billion in 2013 ($6 billion in 2022 dollars). Further, 95% of people living with Alzheimer's and other dementias have at least one other chronic condition, such as heart disease, diabetes, or stroke. Alzheimer's complicates the management of these chronic conditions, resulting in poorer health outcomes and increased health care costs.
Alzheimer's affects more than just the individual with the disease: More than 11 million family and friends provide more than 18 billion hours of unpaid care annually.
A strong public health response can mitigate the future impact of Alzheimer's by utilizing common public health tools and techniques. These include:
- Early detection and diagnosis.
- Reducing risky health behaviors.
- Collecting and using surveillance data.
- Developing workforce competencies.
- Mobilizing partnerships across entire communities.
These population-level interventions help improve the well-being and quality of life for people living with Alzheimer's and reduce the costs associated with it. To help shape that response, the Alzheimer's Association and the Centers for Disease Control and Prevention (CDC) developed the Healthy Brain Initiative (HBI), including its signature guidebook— State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map
. In addition, the Alzheimer's Association runs the CDC-funded Public Health Center of Excellence on Dementia Risk Reduction
How does public health address Alzheimer's?
Public health works to improve the health and well-being for the whole community — at any stage of life, at any age. Even though most people with Alzheimer's are over the age of 65, the brain changes associated with Alzheimer's begin to take root many years, even decades, before symptoms appear. Behaviors and health conditions even earlier can affect a person's risk for later-life dementia. That is why a life-course approach to Alzheimer's and other dementias is needed and why public health must intervene across the lifespan.
This illustration provides a life-course view for people who may eventually develop dementia and for people living with dementia. The semi-circle in purple shows different stages of cognitive functioning from birth to death — beginning with healthy cognition and moving through the pre-symptomatic and mild cognitive impairment stages, and then to dementia. The blue segments represent primary, secondary, and tertiary prevention — the three major opportunities for public health intervention across the life-course:
- Risk Reduction (primary prevention): At any stage of life, public health can reduce the risk of cognitive decline by promoting brain health and healthy behaviors — such as quitting smoking, protecting the head from brain injuries, and being physically active. Learn more about public health and dementia risk reduction.
- Early Detection (secondary prevention): Public health can promote early detection and diagnosis by ensuring that the general public understands the early warning signs of cognitive decline and that health care providers are up-to-date on cognitive issues. See ideas for specific public health action.
- Safety and Quality of Care (tertiary prevention): For people living with dementia, public health can enhance the quality of care through provider education and by educating caregivers about available services and supports in the community. Learn more about public health's role.
Employing these opportunities, public health can intervene to lessen the burden of Alzheimer's, just as public health has helped reduce the burden of heart disease, HIV/AIDS and cancer.