Alabama task force charts five-year plan to tackle Alzheimer’s disease

Rep. Ginny Shaver, R-Leesburg, describes a bill to extend parental leave to state employees on March 21, 2024 in the Alabama House of Representatives at the Alabama Statehouse in Montgomery, Alabama. (Brian Lyman/Alabama Reflector)

The Alabama Alzheimer’s Task Force met Wednesday to develop recommendations for the Legislature for a five-year strategy to address Alzheimer’s and other dementia-related diseases.

The task force, created by a legislative resolution last year , will present the plan to Gov. Kay Ivey and lawmakers at the start of the 2025 legislative session in February, at which time the task force will be dissolved.

“Just looking at what state services are available through the different agencies, we have a member of the committee that’s from the Veterans Affairs, we have Medicaid involved, we have Department of Public Health, [Department of] Mental Health, all of the different state agencies that deal with people who suffer from Alzheimer’s in some form or fashion,” Rep. Ginny Shaver, R-Leesburg, who chairs the task force, said after the meeting.

According to the Centers for Disease Control and Prevention , Alabama in 2021 had the second highest mortality rate from Alzheimer’s disease, behind only Mississippi, at 46.8 per 100,000 people. The 2023 Alabama State Health Assessment identified Alzheimer’s disease as the seventh-leading cause of death in the state in 2022, with a rate of 52.2 people with Alzheimer’s per 100,000 population. That’s an improvement from 2020 , when the state had a rate of 62.9 cases per 100,000 people.

The number of people aged 65 and older with Alzheimer’s disease in Alabama is expected to increase from 96,000 in 2020 to 110,000 in 2025, a 14.6% rise, according to a 2023 report from the Alzheimer’s Association. The increase is mostly due to poor health care access in rural areas and an aging population, particularly in the Black Belt region.

The task force established five subcommittees with different focuses. The plan will also suggest ways to boost public awareness and support family caregivers, as stated in the resolution.

The different subcommittees will focus on caregiver support and education; dealing with stigma; health care provider education; research and policy and advocacy.

Laurie Eldridge-Auffont, chronic disease director at ADPH, said they reviewed plans from other states to guide the task force’s state plan development.

Eldridge-Auffont provided an overview of the Alzheimer’s Association and the Centers for Disease Control and Prevention’s Healthy Brain Initiative, which offers strategies for state and local health departments to build infrastructure for addressing Alzheimer’s. They also reviewed parts of the Massachusetts, Louisiana, and other states’ plan that could be implemented in Alabama.

“This is a good start to see what other states have done so that we’re not reinventing the wheel,” Eldridge-Auffont said.

Amie Brunson, a professor of social work at the University of Alabama, will provide a needs assessment report to the task force.

“We’re looking to ascertain people’s knowledge about dementia and dementia risk, learn about their experience with finding the information activity within their community regarding dementia as well as caregiving,” Brunson said.

Brunson also said that they hope to learn about the public’s perspective on access to public and private organizations working in dementia care.

“I can tell you firsthand that it is quite taxing on caregivers, and I’m probably more connected than most people at seeking out services and finding out what’s available as far as health care and other services,” Shaver said, who is her sister’s caretaker. “For someone with dementia, there’s people who do not have the knowledge and the connections that I have.”

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Alzheimer’s disease disproportionately affects Black Americans. According to a 2022 study by the Alzheimer’s Association, Black Americans are up to twice as likely to develop Alzheimer’s disease, but also 35% less likely to be diagnosed with Alzheimer’s and other dementias than white participants.

The Black Belt region has some of the highest rates of Alzheimer’s disease in the state. In Greene and Macon counties, 18% of the population age 65 and older are living with Alzheimer’s disease, according to the Alabama chapter of the Alzheimer’s Association. The average in Alabama is 11.8%.

Race itself is not a risk factor, according to the study, but certain diseases and lifestyle factors are associated with dementia, with some racial or ethnic groups at greater risk. Cardiovascular conditions such as hypertension and diabetes are more prevalent among Black Americans , which have been consistently associated with dementia and late-life cognitive decline.

Mortality due to Alzheimer’s disease is also increasing in the state, according to the 2022 report. About 2,659 Alabamians died from Alzheimer’s disease in 2019, a 197.1% increase since 2000.

The older population in the nation is increasing, with one in six people being 65 or older (in 1920, that was less than 1 in 20). Alabama’s median age is slightly higher than the national average. The median age in Alabama in 2022 was 39.4 years, according to the U.S. Census , compared to 38.9 years nationwide. The median age was higher among white Alabamians, at 42.9 years .

To create an infrastructure to better connect services around the state, ADPH received a $1.7 million, five-year grant known as the BOLD grant from the Centers for Disease Control and Prevention,

The task force members will be chosen to join the task force subcommittees over the next few weeks. In July and August, subcommittees will meet monthly to draft goals for their priority areas and present these to the task force for discussion and adoption in September and October. The subcommittees will draft objectives for each goal based on a needs assessment being developed by the University of Alabama, which will be distributed statewide for feedback.

From November to December, the subcommittees will draft strategies for each objective and present their findings for the task force. By January, their recommendations are to be finalized and ready to be presented to the legislature in February 2025.

“It’s a five year plan, and years one and two are developing the statewide plan, and then years three, four and five are implementing the plan. What we come up with in the meetings, they will be able to carry it forward and implement it,” Shaver said.

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