By John Shean, MPH, associate director of the Healthy Brain Initiative, Alzheimer’s Association
June is Alzheimer’s & Brain Awareness Month, a time when people around the nation are having conversations about their own cognitive health — and discussing cognitive well-being with friends, family members, and health care providers. The public health community can leverage these conversations to support healthy cognitive functioning throughout the entire year.
Because Alzheimer’s develops over time — often over many years, if not decades — public health professionals have many opportunities to take action. These include:
- Addressing the risk factors for dementia among vulnerable populations
- Advancing early detection and diagnosis of mild cognitive impairment and dementia
- Improving safety and quality of care for people living with dementia
- Providing better support to caregivers
To identify specific ways to take action, public health professionals can look to the Healthy Brain Initiative (HBI) — a public-private initiative that aims to advance cognitive health as a central component of public health practice. The HBI State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map [PDF - 20.3 MB], or the HBI Road Map, offers 25 actions that public health agencies, organizations, and partners can take to address dementia using a population health approach. The HBI Road Map is aligned with objectives in Healthy People 2030, the nation’s health promotion and disease prevention strategy, and supports core functions of public health. What follows are resources that state and local public health agencies can use to shape their own response to Alzheimer’s and dementia.
- Educate and Empower the Nation: Seven actions of the HBI Road Map aim to educate and empower the nation. One specific action calls on public health agencies to educate the general public about cognitive health and dementia, changes in cognition that they should discuss with a health professional, and the benefits of obtaining an early diagnosis.
For example, the Georgia Department of Public Health created Think About It, a robust public awareness campaign about how individuals can reduce their risk of cognitive decline and what they can do if they become worried about their cognitive health. Think About It educates the public about the warning signs of dementia, such as difficulty completing familiar tasks — and strategies people can take to protect their cognition, such as staying physically active.
- Develop Policies and Mobilize Partnerships: Developing plans, programming, and initiatives at the policy or systems level related to cognitive decline, Alzheimer’s, and caregiving can expand reach and create longer-lasting impact than individual interventions. Six HBI Road Map actions are focused on developing policies and mobilizing partnerships. For example, public health agencies could partner with community-based and private organizations to establish policies that promote supportive communities and workplaces for dementia caregivers.
An action brief — Promoting Caregiving Across the Full Community: The Role for Public Health Strategists [PDF - 1.8 MB] — describes the difficulties that caring for people living with dementia poses to communities. It discusses how public health professionals can convene key partners and caregivers to use data and evidence to recognize issues and gaps — and to develop population-wide policies that support and maintain the health, well-being, and productivity of caregivers.
- Assure a Competent Workforce: Both public health professionals and the health care workforce must know how to accurately, appropriately, and comprehensively assess cognitive impairment while applying principles of person-centered care. Seven actions of the HBI Road Map aim to help the public health community ensure a competent workforce, including educating public health professionals about the best available evidence on dementia and caregiving, the role of public health in addressing cognitive issues, and sources of information, tools, and assistance to support action.
A modular curriculum — A Public Health Approach to Alzheimer’s and Other Dementias — can be used to train the current and future health care workforce. The curriculum covers the impact of Alzheimer’s and dementia on individuals and communities, the role of public health to advance cognitive health, and how professionals can apply public health approaches to address this growing challenge. The curriculum is mapped to core competencies for public health professionals and is appropriate for use in schools of public health, related disciplines, and among the current public health workforce.
- Monitor and Evaluate: Data about the prevalence, scope, and burden of Alzheimer’s, dementia, cognitive issues, and caregiving are used to shape priorities, allocate resources, identify gaps, and address disparities. Healthy People 2030 tracks awareness of dementia, hospitalizations in older adults with dementia, and older adults with subjective cognitive decline who have discussed symptoms with a health care provider. The HBI Road Map includes 5 actions aimed at improving monitoring and evaluation to ensure the greatest possible impact and change. One action calls on public health agencies and partners to use data to inform the program and policy responses to cognitive health, impairment, and caregiving.
To assist public health agencies on this front, the Behavioral Risk Factor Surveillance System (BRFSS) offers 2 optional modules — the Cognitive Decline Module and the Caregiver Module — that collect population-based data on cognitive decline and caregiving issues. In fact, the Cognitive Decline Module serves as the data source for Healthy People 2030 Objective DIA-03 which aims to increase the proportion of adults experiencing subjective cognitive decline who discuss their symptoms with a health care provider. Both the Alzheimer’s Association and the Alzheimer’s Disease and Healthy Aging Program at the Centers for Disease Control and Prevention (CDC) produce national, state-specific, and population-specific infographics and facts sheets with this data for use by public health agencies and partners. Additionally, the Alzheimer’s Disease and Healthy Aging Data Portal provides easy access to national- and state-level data on a range of key indicators of health and well-being for older adults, including cognitive health and caregiving.
Around the country, the public health community has the opportunity to elevate attention to cognitive health, Alzheimer’s, and caregiving issues. To find additional resources, data, and information to take action, visit: