One hundred years ago, infectious diseases such as pneumonia and tuberculosis accounted for almost half of all deaths. Today, because of advancements in public health, we can prevent and cure what were once the deadliest diseases in America.
Public health saves lives, and has proven over the past century to extend lives, too. Since 1900, public health has added nearly three decades to the lifespan. The leading causes of death are now chronic diseases including cancer, respiratory diseases, and stroke. Alzheimer’s disease is the sixth leading cause of death in the nation.
While we all may be familiar with the role of public health in protecting against communicable diseases, advancements in public health are beginning to change the story for certain chronic diseases, too. For breast cancer, early detection and screening save lives. The earlier the cancer is caught, the better the prognosis.
As Chairman of the Senate Aging Committee and founder of the Congressional Task Force on Alzheimer’s disease, I recently chaired a hearing to explore how we can tap into public health to rewrite the future of Alzheimer’s disease, just as we have done for so many diseases of the past. Patients, families, and advocates from around the country, including Maine, filled the hearing room with a sea of purple, the signature color worn by Alzheimer’s Association advocates.
They were there in support of the BOLD Alzheimer’s Act that I authored with Sen. Catherine Cortez Masto of Nevada, bipartisan legislation that would establish Centers of Excellence in Public Health Practice dedicated to promoting Alzheimer’s disease management and caregiving interventions as well as educating the public on Alzheimer’s disease and brain health. As part of the national forum that brought the advocates to Washington, Sen. Cortez Masto and I were honored with the Alzheimer’s Association’s 2018 Humanitarian of the Year Award for our work to harness America’s public health infrastructure to enhance access to care and support for people affected by the disease.
An estimated 5.7 million Americans are living with Alzheimer’s, costing our nation $277 billion a year, including $186 billion in costs to the Medicare and Medicaid programs. If we continue along this trajectory, nearly 14 million seniors are projected to be living with Alzheimer’s in 2050, and the cost will surpass $1 trillion annually.
The Centers for Disease Control and Prevention are already doing tremendous work to combat Alzheimer’s within the Public Health Road Map of the Healthy Brain Initiative. The Centers of Excellence created by our bill would implement this CDC Road Map.
BOLD would spread the opportunity for communities across America to create the capacity to combat Alzheimer’s. Our legislation would help public health departments take key steps including education, early diagnosis, risk reduction, care management, and caregiver support.
Early diagnosis makes a difference. Earlier detection of symptoms would provide individuals and families the opportunity to prepare by planning their finances and to find help navigating the challenges of dementia. And it saves money. Just as we screen for cancer, diabetes, and other chronic diseases, appropriate screening for Alzheimer’s is the first step to improve treatment.
Several states and towns are already establishing public health plans to take on Alzheimer’s. I am proud of the actions that Maine is taking to promote early detection and improve data collection. The Maine Center for Disease Control and Prevention has distributed the State Plan for Alzheimer’s, including its special insert with cognitive assessment tools to help primary care professionals make early diagnoses. In Bangor, the Public Health Department has distributed hundreds of brochures to educate the public. In Kennebunkport, Public Health Office nurses are hosting talks on Alzheimer’s to connect people with resources.
Maine also is leading the way in research. Among the witnesses at the hearing was Dr. Gareth Howell of The Jackson Laboratory in Bar Harbor, who testified about the progress of Alzheimer’s research. Over the past five years, Dr. Howell and three of his colleagues have led a diverse and vibrant Alzheimer’s disease research program that aims to find genetic factors that are linked to both susceptibility and resistance to Alzheimer’s. His team also seeks to better understand risk factors and other health conditions that contribute to the disease.
We are making progress in the fight against Alzheimer’s. In 2011, I authored the National Alzheimer’s Project Act (NAPA), with then-Senator Evan Bayh of Indiana. NAPA convened a panel of experts, who determined that $2 billion per year in research funding is needed to achieve our goal of preventing and treating Alzheimer’s by the year 2025. I helped to secure $1.8 billion -- an increase of $414 million -- for Alzheimer’s research in the recent government funding bill, which brings us within reach of the $2 billion goal.
Alzheimer’s is not a normal part of aging. It is a disease and a public health issue with a course that we can potentially change. There are steps that we can take today to help prevent the risk of cognitive decline and to improve the lives of those living with Alzheimer’s and their caregivers. Public health has proven its power to control and prevent infectious diseases. A public health approach to Alzheimer’s can create a better future for persons living with dementia and their families.