Characteristics of At-Risk Population Using Healthy People 2020 Criteria for Dementias

Only 38.4 percent of dementia are diagnosed. This means that a large number of the population in the U.S. living with dementia remain undiagnosed. In most cases, the diagnosis of dementia is delayed and occurs late after the severe manifestations have occurred (Gamble et al., 2022). The Healthy People 2020 has provided criteria for characteristics of the at-risk population of dementia.

According to Healthy People 2020 (HP2020), adults above 65 years are at a higher risk of dementia. Women also have a higher risk of Alzheimer’s disease and other dementias than men. Genetics is also a risk factor for dementia. A family history of dementia predisposes an individual to dementia. As per Healthy People 2020 (HealthyPeople.gov, n.d.), other characteristics of at-risk populations include people from rural areas and minority backgrounds.

Application of HP2020 in the Case of Dementia

HP2020 Goals and Objectives

HP2020 has 42 goals and over 500 objectives that provide guidelines for disease prevention and promotion of health for a decade (Institute of Medicine (U.S.) Committee on Leading Health Indicators for Healthy People 2020, 2011). It supports healthcare system planning, budgeting, and health programming decisions in the U.S. The main goal of HP2020 is to support the achievement of high-quality, extended living for the population by preventing diseases, disability, injury, and early death. HP2020 prioritizes testing to develop early community-level prevention interventions. Therefore, HP2020 promotes quality living through healthy development and adopting population-wide healthy behaviors.

HP2020 Goals and Objectives for Dementias

HP2020 included Alzheimer’s disease and other types of dementias in its health objectives due to the risk dementias pose to the U.S. population (HealthyPeople.gov, n.d.). The specific goals and objectives for dementia focus on reducing the impacts of dementia on the socioeconomic aspects of the U.S. population. The first goal and objective for dementia is to improve the level of dementia diagnosis and awareness of the disorder.

The second objective is to significantly reduce preventable dementia-related hospitalizations, including identifying risk populations and promoting early interventions for dementia cases (Alzheimer Association, 2020). Other HP2020 goals and objectives for dementia include reducing the number of elderly adults with moderate to severe functional disabilities and improving the number of elderly adults participating in light to vigorous activities.

Guidelines and a Screening Method for Dementias

Dementia can be screened based on the cognitive assessment toolkit provided by the Alzheimer’s Association, The Medicare Annual Wellness Visit Algorithm for Assessment of Cognition toolkit. The main practical approaches focus on the clinical recognition of the progressive decline in a patient based on their history, a notable decline in the ability to conduct their daily activities, patterns of mental issues, personality, and behavioral changes over time.

Validity of Screening Tool Method for Dementias

The Medicare Annual Wellness Visit Algorithm for Assessment of Cognition has been validated using the General Practitioner Assessment of Cognition (GPCOG), the Memory Impairment Screen (MIS), the Mini-CogTM, the Short Form of the Informant Questionnaire on Cognitive Decline in the Elderly (Short IQCODE), and the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8). These assessment tools incorporate patient history, concerns of the patient’s caregivers, and the observations of the health professional during an assessment.

The Medicare Annual Wellness Visit Algorithm for Assessment of Cognition has also been validated by research; however, researchers note the need to improve the tool kit. For instance, The tool was found to have a high confidence interval, resulting in increased accuracy when detecting dementia. However, its accuracy has reduced in identifying dementia in high-risk patients with chronic conditions. In addition, the tool has low sensitivity but high specificity; still, outcomes vary across participant characteristics such as race and age (McCarthy et al., 2022).

Population Level Planning Interventions

Nationally, the Alzheimer’s Association, in conjunction with the Centers for Disease Control and Prevention (CDC), established the Healthy Brain Initiative State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map (HBI Road Map). The HBI Road Map provides a framework for partnerships between state and federal