Healthy People 2030 Impact Paper- Dementias
Dementia is associated with a significant decline in cognitive abilities and function, affecting an individual’s ability to perform their activities of daily living. This paper will provide an overview and background of dementia and its significance across the population. It will also analyze the available epidemiological data on dementias, including demographical data and the characteristics of at-risk populations using Healthy People 2030 (HP2030) specified criteria, identify the HP2030 goals and objectives for dementias, and provide guidelines for screening dementias, and review the validity of recommended tools for dementia screening. It will also identify population-level planning interventions in California as well as how outcomes for dementia interventions are measured.
Overview and Background
Dementia is an umbrella term for symptoms related to cognitive decline leading to physical and cognitive dysfunction (Salardini, 2019). The most commonly manifested symptoms of dementia include the inability to communicate well, significant loss of memory, judgment impairment, inability to read, confusion, personality changes, and loss of ability to perform daily activities (Emmady et al., 2022). Based on the DSM-5 criteria for neurocognitive disorders, the major diagnosable dementias are Alzheimer’s disease, Frontotemporal dementia, Lewy body dementia, Vascular dementia, and Mixed dementia (Emmady et al., 2022). There is no single causal factor for dementias. However, the development of dementia is commonly associated with interrelated factors that lead to pathological changes in the brain, such as the environment, genetics, Alzheimer’s disease, traumatic brain injury, and degeneration of the frontotemporal lobar, among other underlying factors. Irrespective of its prevalence, there is no ready cure for dementia. However, the disease can be managed, while some types can be reversed.
Significance of the Problem
The progressive and persistent loss of cognitive function associated with dementia makes it a significant healthcare problem of concern. Dementia has significant social, economic, physical, and mental impacts on patients, caregivers, and society. The significant inability of the individual to function optimally and the progressive decline in both cognitive and physical functioning of the individual leads to an overall loss of independence in patients. People with dementia are prone to getting socially isolated and developing depressive symptoms with reduced quality of life. The burden of the individual on caregivers and relatives can lead to the loss of productivity, financial losses, and increased risk of negative psychological and mental outcomes (Van Den Kieboom et al., 2020). Caregivers are also physically strained, which may further increase the risk of developing physical and mental health conditions.
Dementias are linked to high financial and economic costs related to direct care for dementia patients and lost productivity. The World Health Organization (2023) notes that the global costs of dementia were up to 1.3 trillion U.S. dollars in 2019, with the overall costs of dementia expected to rise above 2.8 trillion dollars annually by 2030. According to White et al. (2019), dementia costs more than $15,700 per patient within the first year of diagnosis. Over 50 per cent of dementia-related costs are directly incurred by informal caregivers such as relatives and close friends. Long-term dementia care may contribute up to 32 per cent of family expenses a year. Dementia is not considered a normal part of ageing. Therefore, it can affect both the young and the aged; however, it mostly affects aged adults, with a higher prevalence among those above 65 years, especially women (Emmady et al., 2022).
Epidemiological Analysis of the Problem
Descriptive epidemiology utilizes observational data from studies on a particular disease. Descriptive epidemiology identifies the ‘what’ aspect of the issue of concern, the ‘who is affected’, ‘where it occurs’, ‘when it occurs’, and the ‘why’ and ‘how’ it occurs. Descriptive epidemiology can help epidemiologists understand disease prevalence, cause factors, disease incidence and mortality rates, costs of care, and at-risk populations and support decision-making for interventions.
Over 50 million people have dementia globally, with the number expected to reach above 131 million by 2050 (Arvanitakis et al., 2019). Alzheimer’s disease is the most commonly identified risk factor for dementia. It is related to approximately 80 per cent of all reported and diagnosed dementia cases. In the U.S., 6.5 million Americans aged above 65 years were found to be living with Alzheimer’s disease as of 2022 (Alzheimer’s Association, 2023). Based on the current trends of Alzheimer’s and dementia, over 9 million Americans will be diagnosed with dementia by 2030 and an estimated 12 million by 2040 (Population Reference Bureau, 2023).
Characteristics of At-Risk Population for Dementias
The Health People 2030 (HP2030) has established various social determinants of health (SDOH) that can help identify at-risk populations for dementia. The HP2030 relates dementia to age, gender, family history, and access to health services. Dementia is higher in women than in men, with dementia being reported in 11 per cent of women in the U.S. and in 8 per cent of men as of 2019 (Population Reference Bureau, 2023). The prevalence rate is also higher in racial minorities such as black and Hispanic populations compared to non-Hispanic white populations. People living alone and those with diseases such as obesity and diabetes are also noted to have an increased risk of developing dementia (Alzheimer’s Association, 2023). The fast-ageing population in the U.S. risks a higher prevalence of dementia.
Application of HP2030
HP2030 identifies the goals and objectives for dementias. The main goal for dementias is to improve the health and quality of life of the population living with dementias, especially Alzheimer’s disease (health.gov, 2023). The objectives the HP2030 has set to achieve this major goal for dementias include increasing the percentage of aged people who are aware of their dementia status, including the caregivers of people living with dementia, and significantly reducing the number of preventable hospitalizations in older adults living with dementia, and reducing the number of adults being diagnosed with subjective cognitive decline by attending to them as soon as they present their symptoms to a provider (health.gov, 2023).
Guidelines and Screening Tools
The recommended screening for dementia is through the use of the available cognitive evaluation tools. The highly recommended screening tool is The Medicare Annual Wellness Visit Algorithm for Assessment of Cognition toolkit.
Validity of the Medicare Annual Wellness Visit Algorithm for Assessment of Cognition toolkit
The Medicare Annual Wellness Visit Algorithm for Assessment of Cognition toolkit has a high validity score and has been noted to improve the management of patients with major neurocognitive disorders (Nicastri et al., 2021), as well as the reduction of disparities in diagnosis and provision of care between people in urban and rural areas (Hanna, 2020).
Population Level Planning Interventions
There are many population-level planning interventions across the U.S. California has put in place various programs as interventions towards improving dementia outcomes at the population level. For instance, the California Alzheimer’s Disease Program (ADP) focused on employing various approaches, such as early diagnosis, to prevent or improve the quality of life for patients with dementia. Another program is Dementia Friends California, which is a population-level movement promoting dementia awareness and community-level education for improving care for dementia patients. The tools provided by HP2030 with regard to dementia focus on the disease, health behaviours, and the population. Regardless of the program, the measures of outcomes generally include dementia health outcomes, level of community awareness, and patient self-reported quality of life.
Conclusion
In conclusion, dementia covers symptoms associated with decreased cognitive functioning. The current prevalence data trends make dementia an issue of public health concern. Dementia has significant social, psychological, and economic impacts on the population. Nonetheless, applying the HP2030 goals and objectives for dementia and evidence-based screening tools for early detection can help develop population- and patient-focused interventions that can improve the social, mental, and economic outcomes of dementia across the community.
References
Alzheimer’s Association. (2023). Alzheimer’s Facts and Figures Report. https://www.alz.org/alzheimers-dementia/facts-figures
Arvanitakis, Z., Shah, R. C., & Bennett, D. A. (2019). Diagnosis and Management of Dementia: A Review. JAMA, 322(16), 1589. https://doi.org/10.1001/JAMA.2019.4782
Emmady, P. D., Schoo, C., & Tadi, P. (2022). Major Neurocognitive Disorder (Dementia). StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK557444/
Hanna, M. (2020). Impact of the Medicare Annual Wellness Visit on Geographic Variation in Dementia Diagnosis. https://archive.hshsl.umaryland.edu/handle/10713/13028
health.gov. (2023). Dementias – Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives/dementias
Nicastri, C., Hensley, J., & Lane, S. (2021). Managing the Forgetful Patient: Best Practice for Cognitive Impairment. Medical Clinics of North America, 105(1), 75–91. https://doi.org/10.1016/j.mcna.2020.09.001
Population Reference Bureau. (2023). Fact Sheet: U.S. Dementia Trends. https://www.prb.org/resources/fact-sheet-u-s-dementia-trends/
Salardini, A. (2019). An Overview of Primary Dementias as Clinicopathological Entities. Seminars in Neurology, 39(2), 153–166. https://doi.org/10.1055/S-0039-1683445
Van Den Kieboom, R., Snaphaan, L., Mark, R., & Bongers, I. (2020). The Trajectory of Caregiver Burden and Risk Factors in Dementia Progression: A Systematic Review. Journal of Alzheimer’s Disease, 77(3), 1107–1115. https://doi.org/10.3233/JAD-200647
White, L., Fishman, P., Basu, A., Crane, P. K., Larson, E. B., & Coe, N. B. (2019). Medicare expenditures attributable to dementia. Health Services Research, 54(4), 773. https://doi.org/10.1111/1475-6773.13134
World Health Organization. (2023, March 15). Dementia. https://www.who.int/news-room/fact-sheets/detail/dementia
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Question 
Please refer to the attached file for topics( PLEASE CHOOSE ONLY ONE TOPIC FROM THESE THREE )
· Arthritis
· Osteoporosis
· Dementias
Week 2
Healthy People 2030 Impact Paper
Assignment
Purpose
The concepts of epidemiology provide the framework for the study of infectious and chronic health issues/diseases, which provides a rich source of data for the analysis of trends in disease and health. This assignment will offer the learner the opportunity to explore the population health effects of a topic assigned by your course faculty.
Healthy People 2030 Impact Paper- Dementias
As an example, you may be asked to identify populations at risk for oral health issues or, for instance, issues related to the frail living at home and design a population health-focused educational intervention for your target population.
In addition, you will look at what outcomes will be addressed to determine if your interventions are effective. This paper should integrate HP2030 and CDC information into your paper.
Link to HP2030Links to an external site.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
CO 3: Identify appropriate outcome measures and study designs applicable to epidemiological sub-fields such as infectious disease, chronic disease, environmental exposures, reproductive health, and genetics.
CO 6: Identify important sources of epidemiological data.
Due Date
Sunday by 11:59pm MT of Week 2
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
Total Points Possible
This assignment is worth 125 points.
Preparing the Assignment
Research Topic: Your course faculty will provide you with topic/s for this assignment. Please check the NR503 Course Announcements.
Identify your target population (for instance, age or other demographic, aggregate population); this must be in your city or state.
Discuss population-based health education interventions for your target population that is aimed at reducing morbidity and mortality for the problem. Be sure to review the research literature and HP2030 for interventions.
Identify how and what data for interventions is being tracked.
In a four (4) page paper, address the following. Refer to rubric for expanded details related to grading expectations.
Identify the problem in the introduction section.
Provide an overview of the problem in your state/national.
Review of descriptive epidemiological and demographic data on mortality/morbidity and risk.
HP2030: Present the goal, overview and objectives of Healthy People 2030 for the paper topic.
Population level prevention and health promotion review. Describe population and/or primary health care focused interventions. Use of scholarly literature and HP2030 is required. There should be direct correlation to evidence for all strategies.
Best Practices in Preparing the Project
Review directions and rubric through carefully.
Follow submission requirements.
Make sure all elements on the grading rubric are included. Organize the paper using the rubric sections and appropriate headings to match the sections.
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.
Title page, running head, body of paper, and reference page must follow APA guidelines as found in the current edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
Ideas and information that come from scholarly literature must be cited and referenced correctly.
A minimum of three (3) scholarly literature references must be used. Not all references should be from scholarly web sites. You may use your textbook, but this will not count towards the three (3) scholarly literature references.
Length: Papers not adhering to the page length may be returned to you for editing to meet the length guidelines.
Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of your own original work for assignments.
Rubric
NR503_HP2030_MAR23
NR503_HP2030_MAR23
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 100 Points
Introduction of the Problem (no heading)
1. Problem is clearly stated.
2. General introduction to the problem supports its importance as a population health issue with data and general statement of scope of problem.
3. Focus of the paper is stated succinctly.
(3 critical elements)
5 pts
Excellent
All bullet items (content) included with depth and consistent connection, validation, by evidence.
4 pts
V. Good
All content included but limited clarity or depth OR Content is missing one critical element.
3 pts
Satisfactory
Content missing: 1. Two critical elements Or 2. Writing lacks clarity, depth
2 pts
Needs Improvement
Content missing: 1. Two critical elements 2. Clarity 3. Problem is unsupported 4. Writing is largely unsupported
0 pts
Unsatisfactory
Section missing
5 pts
This criterion is linked to a Learning OutcomeDiscussion: Overview, Background and Significance of the Problem
1. Provide background and significance of the problem.
2. This includes risks and impact of disease.
3. Data: State and National: Incidence, prevalence, mortality, breakdown by gender/race/religion as appropriately related
(3 critical elements)
25 pts
Excellent
All critical elements (content) included with depth and consistent connection, validation by evidence.
23 pts
V. Good
All content included but limited clarity or depth OR Content is missing one critical element.
21 pts
Satisfactory
Content missing: 1. Two critical elements Or 2. Writing lacks clarity, depth
12 pts
Needs Improvement
Content missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported
0 pts
Unsatisfactory
Section missing
25 pts
This criterion is linked to a Learning OutcomeEpidemiological Analysis of the Problem
1. Using descriptive epidemiology (provide description of term) analyze health problem
2. Include demographic and related epidemiological data
3. Include characteristics of at-risk population using HP2030 specified criteria
(3 critical elements)
30 pts
Excellent
All critical elements (content) included with depth and consistent connection, validation by evidence
27 pts
V. Good
All content included but limited clarity or depth OR Content is missing one critical element.
25 pts
Satisfactory
Content missing: 1. Two critical elements Or 2. Writing lacks clarity, depth
15 pts
Needs Improvement
Content missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported
0 pts
Unsatisfactory
Section missing
30 pts
This criterion is linked to a Learning OutcomeApplication of HP 2030
1. Identify HP2030 goals and objectives
2. Relate HP2030 goals and objectives to health concern topic
3. Identify guidelines and a screening method related to health concern
4. Review validity (predictive power) of screening tool method to include what population the tool is applicable to use with (for instance, adult, child, culture)
(4 critical elements)
20 pts
Excellent
All critical elements (content) included with depth and consistent connection, validation by evidence
18 pts
V. Good
All content included but limited clarity or depth OR Content is missing one critical element.
17 pts
Satisfactory
Content missing: 1. Two critical elements Or 2. Writing lacks clarity, depth
10 pts
Needs Improvement
Content missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported
0 pts
Unsatisfactory
Section missing
20 pts
This criterion is linked to a Learning OutcomePopulation Level Planning Interventions
1. Investigate what is being done at the population health level related to prevention and health promotion for the health problem at the national and state level
2. Identify what and how outcomes are being tracked related to said interventions.
3. Utilize HP2030, CDC, state public health department, research, etc. as resources for interventions and data.
(3 critical elements)
20 pts
Excellent
All critical elements (content) included with depth and consistent connection, validation by evidence
18 pts
V. Good
All content included but limited clarity or depth OR Content is missing one critical element.
17 pts
Satisfactory
Content missing: 1. Two critical elements Or 2. Writing lacks clarity, depth
10 pts
Needs Improvement
Content missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported
0 pts
Unsatisfactory
Section missing
20 pts
This criterion is linked to a Learning OutcomeAssignment Format Possible Points = 25 Points
APA
1. All content accurately utilizes APA format for citations and table formatting per APA current edition.
2. Reference list is formatted per APA current edition.
Cover page, running heads, font size and type, reference list and headings per APA current ed.
15 pts
Excellent
No APA errors
14 pts
V. Good
1-2 APA errors
12 pts
Satisfactory
3-4 APA errors
8 pts
Needs Improvement
5-6 APA errors
0 pts
Unsatisfactory
7 or more APA errors
15 pts
This criterion is linked to a Learning OutcomeGrammar, Syntax, Spelling
1. Grammar, writing voice, and spelling are in accordance with APA current edition.
2. Scientific prose/voice is consistent.
3. Writing has precision and clarity
4. See APA current edition, 3, Writing Clearly and Concisely
10 pts
Excellent
Written work is free of grammatical, spelling or punctuation errors.
9 pts
V. Good
Written work is largely free of grammatical, spelling or syntax errors. (Approximately 1-2).
8 pts
Satisfactory
Written work includes some grammatical, spelling or syntax errors that distract the reader. (Approximately 3-4).
5 pts
Needs Improvement
Written work contains numerous grammatical, spelling or syntax errors that distract the reader (Approximately 5-6).
0 pts
Unsatisfactory
7 or more errors
10 pts
This criterion is linked to a Learning OutcomeLate Penalty Deductions
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
0 pts
Deduction of points
0 pts
Deduction of points
0 pts
Total Points: 125