National Plan to Address Alzheimer’s Disease

The National Plan to Address Alzheimer’s Disease was released in May of 2012. The final version was responsive to some of the concerns APA raised in its comments. APA comments were informed by CONA, and Divisions 40 and 20, and 12 Section 2. The final plan includes a strengthened statement on the need for clinical trials on pharmacologic and nonpharmacologic ways to prevent Alzheimer's Disease (AD) and to manage and treat its symptoms, an objective on continuing clinical trials on the most promising lifestyle interventions, includes psychologists as a member of the skilled workforce, and states that DHHS will disseminate evidence-based, dementia-specific guidelines, including those generated by psychologists. Text was broadened to acknowledge the variety of health care providers, including psychologists, who are involved in assessment, treatment, and care of individuals with AD, in addition to physicians. Our comments noted that neuropsychological evaluation remains a critical component of differential diagnostic methods in discriminating neurodegenerative changes from normal age-related cognitive decline, cognitive difficulties that are related to psychiatric conditions or medical morbidities, and other related disorders. Unfortunately, the plan was not revised to incorporate these facts; however, one recommendation was expanded to note that “once cognitive impairment has been detected, practitioners will be able to consider potential causes of cognitive impairment and determine the need for a comprehensive diagnostic evaluation for AD.”

The recommendations of the Advisory Council on Alzheimer's Research, Care and Servicess were released on the same day as the National Plan. Jennifer Manly, PhD, was a member of Council and chaired its research working group. The recommendations highlight the importance of biological and behavioral markers, as well as behavioral and pharmacologic interventions, and the importance of addressing the current needs of individuals and their caregivers throughout. It is also recommended to expand funding and incentives for health care providers to pursue careers in geriatric specialties, and to redesign Medicare coverage and provider reimbursement to encourage appropriate diagnosis and care planning to diagnosed individuals and their caregivers, including coverage for care planning with a family caregiver even if the individual is not present.