Capito and a bipartisan group of senators write to HHS secretary

on the urgent need to address the growing public health crisis

“Alzheimer’s disease is a growing public health crisis, with an expected increase of nearly 14 million people with the disease in the United States by 2050 “, and that” a significant percentage of dementia could be delayed – and in some cases avoided – in early intervention, wrote the senators.

In urging the HHS to prioritize this issue, Senators Markey, Capito and the group noted that they are, “Confident that a clear goal and strategic investments in health equity will benefit families, society, our economy and the nation.” “

Joining Senator Capito on the letter were US Senators Debbie Stabenow (D-Mich.), Marco Rubio (R-Fla.), Sherrod Brown (D-Ohio), Kevin Cramer (RN.D.), Bob Menendez (DN .J.), James Lankford (R-Okla.), Jacky Rosen (D-Nev.), Jim Inhofe (R-Okla.), Tina Smith (D-Minn.), Roger Wicker (R-Miss.), Richard Blumenthal (D-Conn.), Catherine Cortez Masto (D-Nev.) And Amy Klobuchar (D-Minn.).

Dear Secretary Becerra:

As members of Congress who care deeply about the health of our constituents and the economic health of our country, we write today to urges you to set an ambitious national goal to prevent Alzheimer’s disease and related dementias (MADR) and develop a plan to achieve this goal. We believe reducing the prevalence of dementia should be a priority for the Department of Health and Human Services (HHS).

The proportion of the U.S. population over 55 is growing at a rate 20 times the growth rate of the collective population under 55. Our country’s health care system does not invest enough to keep people healthy until they reach their prime.

Alzheimer’s disease is a growing public health crisis, with an expected increase of nearly 14 million people in the United States with the disease by 2050. By 2021, Alzheimer’s disease and d other dementias will cost the nation $ 355 billion, including $ 239 billion in Medicare and Medicaid. combined payments. Unless you prevent, slow or treat Alzheimer’s disease properly, by 2050 Alzheimer’s disease is expected to cost more than $ 1.1 trillion (in 2021 dollars), a threefold increase in government spending on Medicare and Medicaid and direct spending. .

A significant percentage of dementia could be delayed – and in some cases avoided – with early intervention. In fact, studies indicate that over about 40% of dementia cases are potentially preventable by addressing risk factors such as hypertension, diabetes, depression, physical inactivity, unhealthy diet, smoking, hearing loss, traumatic brain injury, sleep, air pollution and social isolation and loneliness. Many of these factors are also proven risk factors for COVID–19.

A recent survey of healthcare providers found that a healthy lifestyle benefits brain health and that adults in the general population are likely to engage in brain-healthy behaviors if they know that it can help maintain their mental functioning. In addition, 81% of people over 40 would be motivated to adopt a healthier lifestyle to potentially slow the progression of the disease if they found out they had dementia at an early stage.

Unfortunately, our current healthcare system is woefully inadequate:

• Only 16 percent of Medicare beneficiaries report having received a cognitive assessment.

• Less than half of primary care physicians include memory and reflection screening in their standard protocol.

• Primary care practitioners do not consistently promote dementia risk reduction.

• Less than half of beneficiaries with a diagnosis of dementia in their medical file are even informed of their diagnosis by their doctor.

The Centers for Medicare and Medicaid Services (CMS) and other HHS agencies have a significant opportunity to encourage providers, payers to proactively address brain health in healthy and non-symptomatic adults and to strengthen detection early and risk reduction interventions that delay disease progression. These levers include payment reforms, quality incentives, and training of beneficiaries and providers. Above all, overcoming barriers to access and improving the quality of cognitive assessments would be an important first step that can already be taken within existing authorities.

Public health plays an essential role. The National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention (? NCCDPHP), and more specifically its Alzheimer’s and Healthy Aging program, are working to strengthen infrastructure, promoting coordinating health and healthy aging efforts across the CDC and providing a more proactive focus on the social determinants of health and health disparities.

And more needs to be done to prioritize health equity. We urge the HHS to ensure that health systems, researchers and advocates have access to accurate and representative data on Alzheimer’s disease and related dementias and the social determinants of health that shape the risk of Alzheimer’s. In addition, the HHS should make targeted investments – through the National Institutes of Health (NIH) and the Health Resources and Services Administration (HRSA) – in research and treatment infrastructure in communities severely affected by the disease. Alzheimer’s disease and related dementias, with a strong emphasis on community health centers that are under-equipped to provide dementia-related health services.

Early intervention to prevent, diagnose, treat, or slow the progression of Alzheimer’s disease and related dementias would result in substantial savings for the U.S. healthcare system and for families. One estimate predicted that delaying the onset of Alzheimer’s disease by five years would cut Medicare and Medicaid spending by $ 121 billion in the first five years. In 2030 alone, savings would amount to $ 47 billion. In the first 10 years Medicare would save $ 345 billion in total and Medicaid would spend 189 billion less.

On July 19, the National Alzheimer’s Project Act (NAPA) Advisory Council took an important first step. The Council formally recommended that a fifth goal be added to the National Plan to reduce the burden of risk factors for Alzheimer’s disease and related dementias and recommended proportionate strategies and tactics. Aggressive 15% reduction in risk factors could result in up to 1.2 million fewer people living with PMAR by 2050. We urge you to accept this recommendation, add this target to the updated national plan and prioritize its implementation within the HHS.

The Administration and the scientific community have identified Alzheimer’s disease as a priority area – and rightly so. Dementia ranks at the top of the fears of aging Americans and is set to triple by 2060. It is the only leading 10 cause of death in the United States with no known cure. It is also one of the most pressing health inequalities of our time.

We believe that a clear goal and strategic investments in health equity will benefit families, society, our economy and the nation. Any success in preventing or delaying dementia will reduce the financial pressure on Medicare and Medicaid; reduce the cognitive, physical, psychological and economic burden on people living with symptoms and their caregivers; improve the quality of life of patients and caregivers; and increase the likelihood that adults can thrive and remain independent in their later years.

Thank you for your commitment to ensuring the health of our nation. We urge you to redouble this commitment by setting a national goal for the prevention of Alzheimer’s disease. We look forward to and are ready to work with you to support this effort and appreciate your attention to this important matter.

Truly,