Dear Colleague Letter: Detect & Diagnose Alzheimer's Early

November 30, 2016

Dear Colleague:

In New York there are an estimated 390,000 individuals with Alzheimer's disease and other dementias (AD/D), and this number is projected to grow to 460,000 by 2025. The number of New Yorkers with Alzheimer's disease is likely underrepresented due to the lack of early detection/diagnosis and under-reporting on death certificates. The New York State Department of Health strongly urges health care personnel to play their part in the early detection/diagnosis of AD/D. The benefits of early detection include:

  • Symptoms of some dementias can be reversed
  • Increased treatment options and access to information, services, and support
  • Advance planning for health, housing, finance, care and risk reduction
  • Option to participate in clinical trials recruiting individuals in the early stages of dementia
  • Relief gained from better understanding by patients and caregivers
  • Better overall health outcomes
  • Reduced health care costs

The disease is costly and family members often assume the role of providing constant care so that people with AD/D can remain at home and in their community. As a result, the health, well-being and economic condition of caregivers are critical in supporting our system of care. New York State has one million caregivers for persons with AD/D that provide over one billion hours of unpaid care, valuing $14 billion. Providing care to individuals with AD/D has resulted in an estimated $771 million in higher health care costs.

New York's public health response is the implementation of a $25 million Alzheimer's Disease Support Initiative. It is the first of its kind in the nation to support people with AD/D and, especially, their caregivers. The purpose of this Initiative includes preventing emergency room visits and hospitalizations, providing early diagnosis and care, supporting patients at home and in the community, and improving health, quality of life, and well-being for both the patients and their caregivers.

Evidenced-based components of the NYS Alzheimer's Disease Support Initiative include the following:

  • Regional Caregiver Support Initiative projects
  • Caregiver Support for Underserved Populations
  • Centers of Excellence for Alzheimer's Disease
  • Alzheimer's Disease Community Assistance Program
  • Program Evaluation

There are ten Regional Caregiver Support Initiative Projects across New York State. Goals of this project include supporting caregivers through: planning and group activity; improving coordination and access to new and existing support services; expanding and enhancing access to respite services; and limiting all unnecessary transitions. In addition, fifteen organizations are providing Caregiver Support Initiatives for Underserved Populations, which provide similar caregiver core services, resources and education to traditionally underserved communities across New York State.

New York supports ten Centers of Excellence for Alzheimer's Disease. These centers provide comprehensive and coordinated medical services to individuals with AD/D, and support to their families and caregivers. Provided services include disease diagnosis and assessment, patient management and care, medical provider training, collaboration with community organizations, promotion of public awareness of AD/D, and program evaluation to assess the success of the services.

The Alzheimer's Disease Community Assistance Program is a statewide program coordinated with the Coalition of Alzheimer's Association Chapters to provide education and support for people with AD/D, family caregivers, health care personnel, volunteers, community agencies, and first responders. Seven chapters cover core services statewide, such as care planning and consultation, caregiver training, support groups, 24-hour helpline, community awareness, and increased training for important constituencies.

Through a partnership with the University at Albany's School of Public Health, the Department is able to evaluate the effectiveness of the programs and projects making up this NYS Initiative. Common elements of the projects will be measured, the Medicaid impact will be assessed, and findings will be disseminated to the field.

As a health care provider you can help move this agenda forward through: the early diagnosis of dementia; talking to patients and providers about planning for the future; managing co-occurring conditions to maximize health; and developing linkages with community based organizations for patient and caregiver support. Links to resources for each of these focal points are listed below for your convenience.

Thank you in advance for working with us to promote the health of all New Yorkers.

Sincerely,

Howard A. Zucker, M.D., J.D.
Commissioner of Health