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Patricia Coon


It is time we change our thinking on Alzheimer’s disease. Too often Alzheimer’s is treated as an aging issue but, similar to other diseases, Alzheimer’s has a broad impact on communities. It is more than just a health problem. The impact is major, and there are ways to intervene. Alzheimer’s is a public health crisis.

The burden is large and growing. Today, more than 5 million Americans are living with Alzheimer’s. In Montana alone, there are 20,000 people living with Alzheimer’s and thousands of others caring for them each day. It is the most expensive disease in the country. In 2017 the cost of caring for people with Alzheimer’s will be $259 billion, and the costs are expected to rise. By 2050, direct annual costs are expected to rise to $1.1 trillion.

The impact of Alzheimer’s disease is undeniable. Medicare and Medicaid bear two-thirds of the health and long-term care costs of those living with Alzheimer’s. In 2017 alone, Medicare and Medicaid will spend $175 billion caring for individuals living with Alzheimer’s with Montana’s share of the Medicaid cost reaching $139 million.

Through my efforts with the Montana Alzheimer’s/Dementia Work Group and the Alzheimer’s Association, Montana Chapter, key themes have emerged. Alzheimer’s and other related dementias challenge our Montana communities. This is especially true for our rural communities which lack access to specialty or even primary care and community resources. In Montana, individuals with dementia, their family members, and caregivers want and need proactive, comprehensive, high quality care management with accessible, affordable, local community services and resources. It is time to address these issues at all levels - local, state, and national.

BOLD in Congress

Now, Congress has a chance to take a decisive action by passing the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (S. 2076/H.R. 4256). Endorsed by the Alzheimer’s Association and the Alzheimer’s Impact Movement, the BOLD Infrastructure for Alzheimer’s Act would address Alzheimer’s as a public health issue.

Public health works on a population level to protect and improve the health and safety of an entire community or group of people. By working with diverse communities, public health expands the reach and impact of health care efforts. Passing the BOLD Infrastructure for Alzheimer’s Act would multiply our efforts to care for those living with the disease, improve care quality, provide enhanced support for caregivers, and allow us to better understand the disease.

Specifically, the BOLD Infrastructure for Alzheimer’s Act would:

  • Establish Alzheimer’s Centers of Excellence around the country to expand and promote innovative and effective Alzheimer’s interventions.
  • Provide funding to state, local, and tribal public health departments to implement the Public Health Road Map and to promote cognitive health, risk reduction, early detection and diagnosis, and address the needs of caregivers. Public health officials can use the traditional tools and techniques of public health to improve the quality of life for those living with Alzheimer’s and to reduce the costs associated with it.
  • Increase collection, analysis and timely reporting of data on cognitive decline and caregiving. This data is critical to identifying opportunities for public health interventions, helping stakeholders track progress in the public health response, and enabling state and federal policymakers to make informed decisions when developing plans and policies.

This bipartisan bill is already receiving support in Congres where 11 Senators and 57 Representatives have signed on. Please join me in asking Sen. Steve Daines and Jon Tester and Rep. Greg Gianforte to support the BOLD Infrastructure for Alzheimer’s Act today.

Former Surgeon General Dr. David Satcher once said, “Alzheimer’s is the most under-recognized threat to public health in the 21st century.” It is time that we recognize this public health threat and pass the BOLD Infrastructure for Alzheimer’s Act.

Dr. Patricia Coon, of Billings, specializes in geriatric medicine.