Placing Public Health on the ADRD Policy Platform: Building Our Largest Dementia Infrastructure for Alzheimer’s Act

TL;DR

The BOLD Act of 2018 integrated public health into dementia policy, enabling public health departments to support people with dementia and their caregivers.

Contribution

The paper analyzes the BOLD Act as a policy iron triangle and outlines how public health departments have implemented dementia initiatives.

Findings

44 public health departments have adopted the CDC's Healthy Brain Initiative Roadmap.

The BOLD Reauthorization Act of 2024 offers opportunities to sustain and expand dementia care programs.

Collaboration among advocates, officials, and public health is key to advancing dementia policy.

Abstract

The Building Our Largest Dementia Infrastructure for Alzheimer’s Act (BOLD Act) of 2018 placed public health onto the Alzheimer’s disease and related dementias (ADRD) public policy platform, establishing a role for state, local, territorial, and tribal public health departments to address the many challenges faced by persons living with dementia (PLwD) and those who care for them. We consider this remarkable event as another example of policy making iron triangles at both federal and state levels of government, when ADRD advocates, legislative and executive branch staff, and elected public officials who champion PLwD (i.e., a policy making iron triangle) work together to increase public investment in basic research and expand financing for care and support provided to PLwD. Upon recounting passage of the BOLD Act, we move on to highlight how 44 public health departments across the country have since been following the Centers for Disease Control and Prevention (CDC) Healthy Brain Initiative Roadmap, implementing programmatic efforts for PLwD. Referring to the BOLD Reauthorization Act of 2024, we present viable alternatives for public health leadership to sustain and expand such promising advancements bringing essential public health services to PLwD and those who care for them.