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.
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.
- Increased funding for care programs, education, and training related to dementia available through local public health partnerships with the Indian Health Service (IHS)
- The creation of a National Summit on Dementia Risk Reduction, hosted by the CDC
- Expanding access to hearing aids, as hearing loss can be a risk factor for developing dementia
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.
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.
Takeaway
Is there a reason why dementia care is a public health issue?
Dementia care is a public health issue because of the significant emotional and financial burdens it places on family, caregivers, and individuals in our society. That’s not to mention the substantial burden on the health care system and the public health workforce.
How to care for people living with dementia disease?
Caring for someone with Alzheimer’s and other dementias can be challenging. Depending on the individual and the severity of their dementia symptoms, it could be helpful to seek support in the form of health care services. These could include meal delivery services, in-home care, residential facilities, and adult day programs. If you’re taking care of a family member at home, try to create a familiar environment and daily routine.
Is there a reason why dementia care is a public health issue that needs immediate attention?
There is no known cure for dementia, and it presents a significant burden to society on both an institutional and personal level. For this reason, it’s a public health priority. The prevalence of dementia has a significant impact on Medicare costs, and this burden is projected to worsen as Medicare beneficiaries age. Early diagnosis and treatment could assuage these costs, which is why there is now a cognitive assessment performed during the Medicare annual wellness visit.
How can people living with dementia disease live well?
According to the National Institute on Aging, eating healthy foods, exercising regularly and remaining social can help people live well, despite having dementia.
Why is dementia an issue for society?
There are many reasons why dementia is a significant issue for society. Some of these reasons include:
- More than 55 million people suffer from dementia worldwide.
- A systematic review of dementia research revealed significant gaps in our understanding of the global prevalence and incidence of dementia.
- Dementia is the seventh leading cause of death in the United States.
- Dementia affects the older adult population, a group already experiencing a high burden of health care costs.
- Emergency department visits are 40% more common among people with dementia, a statistic that underscores the burden dementia places on the healthcare system, including primary care and emergency care.
- Minority groups, including certain racial and ethnic groups, are disproportionately affected by dementia, adding to the health disparities that already exist in health care.
- According to the National Alliance for Caregiving, the number of people with dementia in the U.S. will continue to grow over the next several years as the baby boomer population ages. This will increase the economic burden and put even more strain on health professionals and informal caregivers.
Why is dementia a national health priority?
Health care costs for dementia totaled nearly $3.5 billion in 2023. The cost alone has gotten the attention of public health leaders, but there are other pressing issues as well, including health equity. Racial and ethnic differences among people with Alzheimer disease and other dementias is something that must be addressed if achieving health equity is a priority.
According to the National Institutes of Health, racial and ethnic estimates of dementia in the U.S. indicate a significant disparity, with African Americans, Hispanic people, and other ethnic minority groups at a higher risk of diagnosis. There are also ethnic disparities in diagnosis and dementia treatment, with Native American and Asian people at a higher risk for late diagnosis.
What type of health issue is dementia?
Aside from being a major public health issue, dementia is considered a neurodegenerative brain disorder that primarily affects older adults in diverse populations.
Why should we raise awareness for dementia?
Each year, Alzheimer’s Disease International organizes World Alzheimer’s Month to bring awareness to Alzheimer’s and other dementias. There could be many reasons why raising awareness for dementia is important. Here are some examples:
- To draw attention to the economic burdens placed on the health care system as well as individual payers as a result of dementia
- To highlight ethnic differences in dementia diagnosis and medical care, especially in underserved populations
- To address Alzheimer’s disease and reduce caregiver burden, emphasizing the importance of caregiver support
- To ensure quality services are provided for dementia patients, including paid services and unpaid services
- To make the public aware of the social determinants of dementia, including age, education, socioeconomic status, and social isolation
- To educate the public about symptoms of mild cognitive impairment and the risk it poses of a future dementia diagnosis
Why is dementia care important?
According to the CDC, caregivers for dementia patients provide an essential public health service. There are many different types of caregivers, including family members, in-home caregivers, and caregivers in community living settings.
Dementia caregiving is important to preserve the quality of life and dignity of the oldest members of our society. The burden on the dementia care workforce and unpaid caregiving is significant, though. According to the Substance Abuse and Mental Health Services Administration, more than 1.5 million older adults live in nursing homes and long-term care facilities.
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