Assignment Instructions
Healthy People 2030 Impact Paper
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 which will be assigned by your course faculty.
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.
Sample Answer
Dementia is not a specific condition but it is a general term that refers to impaired thinking, decision-making, and the ability to remember. The most common type of dementia is Alzheimer and currently, 5.8 million people in the United States suffer from Alzheimer's and other types of dementia. This includes 5.6 Million people aged 65 years and above and 200000 people aged 65 years and below. Dementia progresses with age and it is majorly common among people as they age. The conditions can be caused by different diseases that damage the brain and destroy nerve cells over time leading to damaged cognitive function. Though the condition does not affect an individual's consciousness, it impairs function and leads to changes in controlling emotion, mood, motivation, and behaviors. On occurrence, dementia results in economic, social, psychological, and physical effects not only for the patients with dementia but also for their families, caregivers, and society in general. Lack of awareness of dementia results in stigmatization and this is a barrier to its diagnosis and provision of care on diagnosis. This paper will provide a
Overview, Background, and Significance of the Problem
Dementia results in significant costs as in 2023, it is estimated that dementia will cost the United States $345 Billion. This amount excludes the costs incurred on Medicaid and Medicare which is up to $222 Billion while the out-of-pocket expenses total up to $87 Billion. By 2050, the total payment for hospice care, long-term care, and healthcare for patients with dementia is estimated to be approximately $1 trillion. The total lifetime cost of caring for a patient suffering from dementia is estimated to be $392,874 (Alzheimer's Association, 2023). Patients living with dementia spend twice as much time at the hospital than individuals suffering from other conditions. Medicare beneficiaries with dementia are more likely to suffer from chronic conditions such as kidney diseases, diabetes, and cardiovascular diseases. The elderly living with dementia require staying in skilled nursing facilities and home healthcare visits than other elderly.
The number of people in America living with Alzheimer's is increasing fast and in 2023, 6.7 Americans aged 65 years and above have Alzheimer's. 73% of this population is aged 75 years and above. 10.7% of elderly aged 65 years and above suffer from Alzheimer and two-thirds of people suffering from dementia are female (Alzheimer's Association, 2023). Old Black Americans are two times more likely to suffer from Alzheimer's and other types of dementia. Older people of Hispanic origin are one and a half times more likely to suffer from dementia than the white population. There are various modifiable risk factors of dementia and this includes behaviors and lifestyle that reduce or increase the risk of the condition. A lot of modifiable risk factors of dementia are related to chronic conditions and cardiovascular diseases. The risk factors include; not engaging in adequate physical activities, hypertension, diabetes, binge drinking, loss of hearing, smoking, and depression. Maintenance of a healthy lifestyle and management of chronic conditions is essential in improving brain health and general health. It also leads to slow progression of disease and a decrease in the risk of dementia (CDC, 2022).
Epidemiological Analysis of the Problem
Over time, the proportion of elderly people aged 70 years and above reduced from 13% in 2011 to 105 IN 2019. The rate of the elderly suffering from dementia is estimated to be reduced by a rate of 1% to 2.5% annually depending on the age group or time frame examined. However, as the baby boomers are heading to the elderly age, the number of people suffering from dementia is likely to increase significantly. If this trend continues, it is projected that 12 Million people will be suffering from dementia by 2040 (PRB, 2021). The at-risk population of dementia is the elderly who are likely to be coping with various health conditions and changes in health. An elderly person is likely to suffer from dementia due to damage to the blood vessels in the brain, elevated blood pressure, risks of stroke, weakened immune system, inactive brain cells, and slow ability to recover from injuries. As a person advances with age, they become frailer and this increases the risk of development of memory and thinking ability.
Application of HP 2030
It is estimated that, by 2060, almost 25% of the United States population will be 65 years and above. Healthy People 2030 core objective focuses on improving the quality of life and health of the elderly who are at risk of conditions such as dementia. This objective can be measured through the collection of data that is necessary to track the progress. The objective can be met by measuring any increase in the proportion of the elderly living with dementia, reduction of the rate of hospitalization among the elderly with dementia, and increase in the number of adults suffering from Subjective Cognitive Decline and individuals suffering from memory loss and confusion (CDC, 2020). One of the screening tools for dementia is the Mini-Mental State Examination (MMSE). MMSE is a short screening tool that measures cognitive impairment in research, clinical and community settings. Some of the aspects tested by MMSE are attention, concentration, a test of orientation, visuospatial and naming skills, and verbal memory (Sleutjes et al., 2020). Though MMSE is widely used to screen dementia, its validity is impaired by several shortcomings. The tool lacks sensitivity for detecting Mild Cognitive Decline (MCD) and fails to differentiate between patients with older controls and those with mild dementia especially among individuals who are highly educated. Additionally, there is poor standardization and a lack of parallel versions across different countries.
Population Level Planning Interventions
There exists a relationship between lifestyle behaviors and dementia. Approximately 50% of adults living with high blood pressure and who do not meet the aerobic physical activity guidelines are more likely to have dementia. The elderly experiencing subjective cognitive decline such as loss of memory and confusion are likely to report risk factors for dementia at 34.3% than the people experiencing cognitive decline at 13.1%. 3.9% of the elderly with no dementia risk factors report subjective cognitive decline and 20.5% of the elderly with four risk factors of dementia reported a decline in cognitive ability (CDC, 2022). The modifiable risk factors of dementia are common among the Alaska Native Populations, American Indians, Hispanics, and African Americans. Health promotion strategies for Dementia focus on modifying lifestyle choices. It will involve the prevention and management of high blood pressure as a lot of the elderly with high blood pressure are unable to manage it. Management of blood sugar is crucial in diabetes management and a healthy weight can obtained by participation in regular physical activity and healthy eating that helps in maintaining a healthy weight. Maintenance of physical activity reduces the risk of anxiety and depression, improves the thinking of the elderly, and helps one to sleep better. Individuals who smoke should quit smoking and this is necessary for maintaining brain health and reducing the risk of lung disease, cancer, heart disease, and other smoking-related diseases (Wahl et al., 2019). Other interventions would include limiting excessive drinking, preventing and correcting any loss in haring, and sleeping enough of 6 to 8 hours. The outcomes of these interventions will be measured by assessing the general well-being of the elderly, regular screening for diabetes and high blood pressure, and using tools such as MMSE to measure the cognitive abilities of the elderly.
References
Alzheimer's Association. (2023). Alzheimer's Disease Facts and Figures. https://www.alz.org/alzheimers-dementia/facts-figures#:~:text=People%20living%20with%20Alzheimer's%20or,disease%2C%20diabetes%20and%20kidney%20disease
CDC. (2020). Healthy people 2030, dementias including Alzheimer's. Centers for Disease Control and Prevention. https://www.cdc.gov/aging/publications/healthy-people-2030/index.html
CDC. (2022). Dementia risk reduction. Centers for Disease Control and Prevention. https://www.cdc.gov/aging/publications/features/dementia-risk-reduction-june-2022/index.html
CDC. (2022). Reducing Risk of Alzheimer’s Disease. Centers for Disease Control and Prevention. https://www.cdc.gov/aging/publications/features/reducing-risk-of-alzheimers-disease/index.htm#:~:text=Promoting%20healthy%20aging%20and%20reducing,cigarette%20smoking%20and%20excessive%20drinking
PRB. (2021). Fact Sheet: U.S. Dementia Trends. Population Reference Bureau. https://www.prb.org/resources/fact-sheet-u-s-dementia-trends/#:~:text=Estimates%20vary%2C%20but%20experts%20report,nearly%2012%20million%20by%202040
Sleutjes, D. K., Harmsen, I. J., van Bergen, F. S., Oosterman, J. M., Dautzenberg, P. L., & Kessels, R. P. (2020). Validity of the mini-mental state examination-2 in diagnosing mild cognitive impairment and dementia in patients visiting an outpatient clinic in the Netherlands. Alzheimer disease and associated disorders, 34(3), 278. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497592/
Wahl, D., Solon-Biet, S. M., Cogger, V. C., Fontana, L., Simpson, S. J., Le Couteur, D. G., & Ribeiro, R. V. (2019). Aging, lifestyle and dementia. Neurobiology of disease, 130, 104481. https://www.sciencedirect.com/science/article/pii/S0969996119301329