The National Alzheimer's Project Act (NAPA) Advisory Council recently convened to discuss strategies for mitigating dementia risk factors across the lifespan. Here are the key recommendations presented by the Risk Reduction Subcommittee tasked with implementing Goal 6 of our nation’s plan to address Alzheimer’s: Accelerate Action to Promote Healthy Aging and Reduce risk Factors for Alzheimer’s Disease and Related Dementias. UsAgainstAlzheimer’s worked with hundreds of organizations to add Goal 6 to the National Pan.  These recommendations are conveyed to the Secretary and to Congress.

Identify and Track Priorities:

• Reauthorize NAPA for another ten years.
• Focus on Six Key Risk Factors: midlife hypertension and obesity, physical activity, smoking, depression, and hearing loss.
• Establish a Monitoring and Evaluation Workgroup: The Department of Health and Human Services (HHS) should establish this workgroup no later than May 2025 to make recommendations for specific indicators and related data sources.
• Track Prevalence: Monitor prevalence by race/ethnicity, education, income, and among those with neuro-atypical conditions.
• Public Report on Spending: HHS should issue a public report on current federal and state-level spending on activities addressing cognitive decline and dementia risk factors. Each year, the Office of Management and Budget should identify the amounts proposed in the budget request for addressing these factors across federal agencies.
• Second AD/ADRD Risk Reduction Summit: Convene a second summit by 2028.

Public Health and Aging Network Action:

• Strengthen Public Health and Aging Network Infrastructure.
• Reauthorize the BOLD Infrastructure for Alzheimer’s Act and the Older Americans Act.
• Increase Funding for Federal Programs: Create new programs that support risk reduction for cognitive decline.
• Expand Efforts Targeting Dementia Risk Factors through education and outreach.

Clinical Care Interventions:

• Comprehensive Actions by Payers and Health Systems: Public and private payers, health systems, and provider networks should identify and implement actions that assess cognitive decline and dementia risk factors, ensuring equitable reach and impact.
• Integrate Evidence into Clinical Practice on risk factor reduction.
• Develop Models of Care: Increase the uptake of evidence on risk reduction in primary and ambulatory care.
• Align Public Health and Healthcare Interventions to reduce population risk.

Research Initiatives:

• Increase Research on Causal Pathways: Understand the causal pathways for dementia and the social determinants of health affecting dementia risk.
• Support Translational Research and Models of Care: Increase evidence uptake in clinical practice.

Non-Governmental and Private Sector Efforts:

• Cooperation by State Health Departments and Agencies: Address dementia risk factors collectively.
• Investment by Foundations and Charitable Organizations: Focus on brain health initiatives.
• Promotion by Employers and Community Organizations: Engage in efforts such as hypertension management and physical health promotion.

Policy Implementation:

• Implement Policies at Federal, State, and Local Levels: Address risk factors for cognitive decline and dementia, including improving food quality, increasing physical activity opportunities, and expanding hearing testing and preventive health care.

These recommendations aim to reduce the risk of cognitive decline and dementia through a comprehensive approach involving reauthorization of key acts, public health infrastructure enhancement, clinical care improvements, research, and coordinated efforts across various sectors. 

You can view the full recommendations by the Risk Reduction Committee here, and the recommendation’s for implementing other NAPA goals here.