Since 2011, a total of 47 states and territories have used or agreed to use the Cognitive Impairment Module in their annual Behavioral Risk Factor Surveillance System (BRFSS) surveys, leaving only five states – Colorado, Delaware, Montana, Pennsylvania, and Rhode Island – that have failed to do so. 

The BRFSS survey is used to identify trends, estimate burden, and track patterns of disease. For Alzheimer's disease and cognitive health, surveillance is an essential tool in understanding the disease at the state and local levels. The Cognitive Impairment Module will provide the research and public health communities with a better understanding of people with cognitive impairment and Alzheimer’s disease, identify opportunities for reducing the impact of the disease, and enable state and federal policymakers to make the best decisions in developing Alzheimer’s-related policies.  No other module has been adopted so widely or so quickly in the history of the BRFSS outside a core program of the Centers for Disease Control and Prevention (CDC). Data from the 22 states that asked the questions in 2011 will be available soon. 

The Alzheimer’s Association has provided funding, through its Cooperative Agreement with the CDC Healthy Aging Program, for the cost of including the module. If your state is interested in including the module for the first time or continuing its use of the module, please contact Catherine Morrison.

New Study Highlights Connection between Smoking and Cognitive Function

A new study suggests that smoking can damage your brain, finding a consistent association between smoking and lower cognitive function, including memory. The cohort study from the English Longitudinal Study of Ageing (ELSA) evaluated cardiovascular risk factors and 10-year Framingham risk scores with cognitive outcomes at 4-year and 8-year follow-ups. Three measures of cognition were used: memory, executive function, and cognitive index. At each follow-up and across each measure of cognition, a consistent association was observed between smoking and lower cognitive function.  The study also indicates that high blood pressure may affect cognitive decline and is likely to develop over a period of time. This latest study adds to a body of research showing that smokers are often at a higher risk of cognitive decline than non-smokers. While additional research is needed, this study suggests that smoking and long-term high blood pressure may increase the risk of cognitive decline.

The researchers suggest the most promising prevention and health promotion approach is one aimed at multiple vascular risk factors. For the public health community, this emerging evidence provides an opportunity to incorporate brain health messages into anti-tobacco efforts.

Alzheimer's Impact Survey Calls for Increased Public Education

A recent report detailing public attitudes and knowledge of Alzheimer’s disease suggests major educational campaigns are necessary to increase knowledge and awareness of the disease and dispel incorrect information. Over 2,600 adults were surveyed in France, Germany, Poland, Spain, and the United States on their knowledge of and beliefs about Alzheimer's disease severity, current treatments, available diagnostic testing, common symptoms, and level of government spending.    

Among the results, the survey found that many individuals across the five countries incorrectly believe:

• Treatments are currently available to slow the progression of Alzheimer’s
• A reliable test is available to determine if a person suffering some memory loss is in the early stages of Alzheimer’s
• Alzheimer’s disease is not fatal 

Some attitudes and beliefs varied according to the individual’s personal connection to the disease, but the authors suggest wider family experience with the disease will not change most attitudes and beliefs about Alzheimer’s. Rather, widespread educational campaigns are necessary. Without such efforts, the authors conclude, the public’s attitudes are unlikely to change.

The findings of this study should serve as a clarion call for the public health community to engage in efforts to dispel myths and reduce stigma surrounding Alzheimer’s disease.

Dementia is Second Major Contributor to Death in Older Adults 

According to official mortality data, over 83,000 Americans died of Alzheimer’s disease in 2010 – the sixth leading cause of death in the United States.  Several studies have shown over the years that this number likely underestimates the number of deaths from Alzheimer’s disease. And now a new study has found that dementia is the second highest contributor to deaths among seniors, even when it is not the direct cause of death. Claims data were examined from 22,890 participants in the Medicare Current Beneficiary Survey.  Researchers found that dementia contributes to 13.6 percent of deaths in older adults, second only to heart failure. The researchers concluded that dementia is “a potent contributor” to death in older Americans.