Health Policy And Dementia: Why Dementia Care Is A Public Health Issue

Dementia can be seen as an umbrella term referring to symptoms of cognitive decline, which can include memory loss, sensory impairment, and decreases in executive function that may eventually interfere with a person’s ability to complete daily tasks. Dementia symptoms can have a number of causes, from more well-known conditions like Alzheimer’s disease to rarer illnesses like frontotemporal dementia. Dementia is often associated with aging, as it can be more common in people over 65 years of age, but dementia symptoms can occur in younger people as well. 

The CDC Foundation, affiliated with the U.S. Centers for Disease Control and Prevention, defines public health as “the science of protecting and improving the health of people and their communities by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing, and responding to infectious diseases.” Addressing the behavioral and psychological symptoms associated with dementia can be an essential component of a functioning public health system, and it is likely to become even more important as the American population ages and dementia is projected to become more common. Resources like online therapy platforms may also be essential for providing necessary care to those with dementia and their loved ones.

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How public health measures can improve brain health

Public health measures to address and combat dementia may be most effective when they are not exclusively targeting older people or those who already have the disease. Brain changes associated with dementia can develop years before symptoms begin (vascular dementia may be an exception to this rule, as dementia symptoms can develop rapidly after a person experiences a cardiovascular event like a heart attack or stroke).

Several risk factors for dementia involve behaviors and health decisions a person makes over the course of their entire life, so public health intervention for dementia may be necessary at all stages of life to enhance prevention efforts. Public health interventions can help with risk reduction, early detection and diagnosis, and safety and quality of care for people living with dementia. 

Public health interventions for dementia can include the following:

• Educating people about effective lifestyle changes they can make to reduce their dementia risk, such as eating nutritious food, exercising regularly, and maintaining lower blood pressure
• Shifting the culture around cognitive impairment and memory problems, i.e., pushing back against labels like “senile” or “having a senior moment”
• Keeping healthcare providers informed on the latest research regarding dementia prevention and treatment for different forms of the disease
• Expanding access to financial and legal planning services, support programs, clinical trials, and resources for caregivers
• Boosting knowledge of care services
• Improving connections between community care programs and clinical care programs
• Providing training for care providers, including family members 

Why is it important to have a public health response addressing dementia?

Dementia tends to be a serious health condition that can lead to many problematic health and societal outcomes. Statistics from the Alzheimer’s Association – which only measures the impact of Alzheimer’s disease, one of many causes of dementia – may indicate the scale of concerns related to dementia:

• Almost seven million Americans are currently living with Alzheimer’s disease.
• The United States is estimated to spend $360 billion in total on caring for people with Alzheimer’s disease in 2024.
• Because the U.S. population is estimated to become significantly older in the next few decades, dementia is likely going to become an even more serious and expensive public health concern. By 2050, it is estimated that almost 13 million Americans will have Alzheimer’s disease, costing the nation almost $1 trillion.
• Dementia can have a substantial impact on caregivers as well. The Alzheimer’s Association estimates that roughly 11 million people served as caregivers for someone with the condition in 2023, adding up to 18 billion hours of care work that cost almost $350 billion.
• Two-thirds of the cost of healthcare for patients with Alzheimer’s disease is paid for by the federal government or state governments through financial assistance programs like Medicare and Medicaid.

Dementia can also worsen the health impact of several other conditions, increasing care needs and healthcare spending for those diseases as well. These illnesses may include diabetes, heart disease, and stroke complications, all of which can also worsen dementia symptoms. 

Steps toward a public health dementia response

Large national and international public health agencies have taken steps to recognize the serious need for dementia care. The World Health Organization (WHO) has created a Global Action Plan through their Global Dementia Observatory (GDO). The plan calls for 75% of countries to have national policies, plans, strategies, or frameworks for addressing dementia by 2025. These plans must be codified by legislation or have formally allocated funds for implementation to meet the WHO’s recommendations. 

Similar efforts are underway in other countries, including the United Kingdom’s National Health Service (NHS, the British equivalent of the U.S. Department of Health and Human Services). The NHS has officially incorporated dementia into its All Our Health initiative to empower healthcare professionals with the tools they need to prevent illness and promote well-being.  

Find support for navigating the impacts of dementia

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Finding additional support for living with dementia or caring for a dementia patient

In a country with a population as large as the United States, public health resources for people with dementia can vary by state or even by city. In some cases, people with dementia or their caregivers and loved ones may need additional support, especially when coping with the mental health impacts of the condition. In this case, it may be helpful to talk to a licensed professional counselor.

However, attending a therapy session could present complications for a dementia patient or caregiver. Transportation could be a concern for individuals with dementia, and caregivers may not be comfortable leaving their loved ones unsupervised. Online therapy, through which sessions can be attended from anywhere with an internet connection, may bridge this accessibility gap. 

Effectiveness of online therapy

Studies have found that attending therapy online can be just as effective as attending traditional in-person therapy sessions. One group of researchers studied the impact of online therapy on a group of dementia caregivers, finding that completing a course of online therapeutic treatment typically lessened symptoms of anxiety and depression. Online therapy could be a helpful resource to supplement the public health support dementia patients and caregivers deserve.