NATIONAL PLAN TO ADDRESS ALZHEIMER'S DISEASE: 2017 UPDATE. Strategy 5.A: Enhance the Federal Government's Ability to Track Progress

09/01/2017

New Tool Enables Easier Tracking of NIH Research Milestones. NIH launched the Alzheimer's Disease and Related Dementias Research Implementation Milestone Database, a user-friendly web-based tool to track NIH funding initiatives and activities, targeting milestones aimed at achieving the Plan's ultimate research goal. Through the milestone database's linkage to IADRP, this resource encourages funders to coordinate and collaborate to maximize the impact of their collective investment in dementia research. It provides the public an easy-to-use but comprehensive window into the full landscape of research funded by NIH and provides a platform for other funders to also post their funding opportunities. Milestones currently track the entire AD/ADRD research landscape, including basic, translational, and clinical and health services research. The new AD/ADRD milestones from the NINDS-led summit in 2016 were added to the database in 2017.

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CDC Data Reports and Publications -- Increase in Alzheimer's Disease Deaths. CDC released Deaths From Alzheimer's Disease -- United States, 1999-2014 in May 2017. The authors found that death rates for AD have increased 55% from 1999 through 2014. These increases were seen in most states, all age groups, and all racial and ethnic groups examined. This article includes a county-level map of AD deaths that shows higher rates in the Southeast and some areas of the Midwest and West.

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Behavioral Risk Factor Surveillance System Data and Data for Action. CDC worked with partners and revised the BRFSS Cognitive Decline and Caregiving Optional Modules, which were approved as official optional modules beginning in 2015. In 2015 and 2016, 51 states and territories collected data using the Cognitive Decline Module and 40 states collected data using the Caregiving Module. Additional states are collecting data using the Cognitive Caregiving Modules in 2017. Findings from the 2015 cognitive and caregiving data are publically available on CDC's Healthy Aging Data Portal and fact sheets and infographics were developed for each participating states. Findings from 2016 BRFSS will be released late in 2017.

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National Health and Nutrition Examination Survey. CDC supported the development and collection of subjective cognitive decline and cognitive functioning data from the in-person National Health and Nutrition Examination Survey (NHANES) are publically available for download and analysis. These data were collected in adults 60 years and older as part of the 2011-2012 and 2013-2014 data collection cycles. The data included in this release include results from three tests of cognitive function: (1) the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning subtest; (2) a test of Animal Fluency; and (3) the Digit Symbol Substitution Test.

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CDC's Healthy Aging Data Portal. The portal was updated with CDC Updates Public Data Portal on the Health of Older Adults. CDC recently updated the Healthy Aging Data Portal, which provides access to a range of national, regional, and state data on older adults. This resource was developed by the National Center for Chronic Disease Prevention and Health Promotion. It allows users to examine data on key indicators of health and well-being for older Americans, such as tobacco and alcohol use, screenings and vaccinations, and mental and cognitive health.

2015 BRFSS data includes data on cognitive decline from 35 states and data on caregivers from 24 states. Portal users can retrieve CDC data by indicator or by geographic area, and then use these data to develop reports and create customized maps, charts, and graphics. Public health professionals can use the data to create a snapshot of the health of older adults in their states, which can help them prioritize and evaluate public health interventions.

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Needs Assessment Toolkit. CDC supported the Alzheimer's Association to develop a Needs Assessment Toolkit that serves as Guidance and Resources for State Public Health Agencies on Comprehensive Needs Assessments Related to Alzheimer's and Other Dementias. This document aims to increase the use of information and insights to appropriately respond to the growing public health burden associated with AD/ADRD through comprehensive needs assessments. These are at the core of a state's ability to effectively use information to develop, implement, and maintain state plans that are focused either exclusively on AD/ADRD, or more broadly on the incorporation of cognitive health and impairment into other state public health plans. Public health agencies have a high level of expertise related to developing and conducting needs assessments. This toolkit has been developed to help states leverage their expertise in conducting needs assessments to enhance their ability to gather and use information specifically related to AD/ADRD.

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Diagnostic Coding for Dementia. HHS continues to partner with VA and other federal partners to examine AD/ADRD diagnostic codes and coding practices for federal agencies to use in analyses of administrative data to enhance reporting. The work will help prioritize research, clinical services, and caregiving resources.

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Quality Measures Under Consideration. CMS publishes a list of quality and cost measures (the "MUC List") under consideration for certain Medicare quality and value-based purchasing programs annually. The current list includes MUC 16-317, Safety Concern Screening and Follow-Up for Patients with Dementia: "Percentage of patients with dementia or their caregiver(s) for whom there was a documented safety screening in two domains of risk: dangerousness to self or others and environmental risks; and if screening was positive in the last 12 months, there was documentation of mitigation recommendations, including but not limited to referral to other resource."

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Progress in Dementia Measure Development. Measures have been in development to examine the evidence base and measurement gaps to develop de novo electronic clinical quality measures (eCQMs) related to dementia care. CMS has worked on two measures: (1) Cognitive Impairment Assessment Among Older Adults (75 years and older) -- Cognitive Impairment; and (2) Documentation of a Health Care Partner for Patients with Dementia or MCI -- Health Care Partner. The measures are under consideration for use in CMS's Quality Payment Programs.

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