[Congressional Record Volume 170, Number 23 (Thursday, February 8, 2024)]
[Senate]
[Pages S497-S498]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself, Ms. Cortez Masto, Mrs. Capito, and 
        Mr. Kaine):
  S. 3775. A bill to amend the Public Health Service Act to reauthorize 
the BOLD Infrastructure for Alzheimer's Act, and for other purposes; to 
the Committee on Health, Education, Labor, and Pensions.
  Ms. COLLINS. Madam President, I rise today to introduce legislation 
to reauthorize the Building Our Largest Dementia, BOLD, infrastructure 
for Alzheimer's Act, legislation I authored that was signed into law in 
2018.
  The Building Our Largest Dementia, BOLD, Infrastructure for 
Alzheimer's Reauthorization Act of 2024, which I am pleased to 
introduce today with my colleagues Catherine Cortez Masto, Shelley 
Moore Capito, and Tim Kaine, would continue our important work to 
create a public health infrastructure to combat Alzheimer's disease and 
preserve brain health.
  Public health plays an important role in achieving population-level 
improvements, but for too long Alzheimer's and other dementias have 
been viewed as just a normal part of aging and not as the public health 
crisis it warrants. Through the BOLD Act, we started to change this 
narrative and for the first time put resources behind the interventions 
that can help improve the health and quality of life for people living 
with Alzheimer's, as well as reduce the costs associated with the 
disease.
  Still, Alzheimer's disease remains one of the greatest public health 
threats of our time. Approximately 6.7 million Americans are living 
with the disease, and, barring any major breakthroughs to prevent, slow 
down, or cure Alzheimer's, that number is expected to more than double. 
In addition to the human suffering it causes, Alzheimer's is one of our 
Nation's most expensive diseases, costing an estimated $345 billion 
last year. In my home State of Maine, more than 29,000 seniors are 
living with the disease, and unfortunately that number is only 
increasing. In addition, more than 51,000 loved ones are providing care 
valued at nearly $1.9 billion. Every State across the country is 
experiencing a similar story, underscoring the need to invest in the 
development of a robust Alzheimer's public health infrastructure on a 
State, local, and Tribal level to combat this growing public health 
crisis.
  Through coordinated Federal investments and a national strategy 
created by the National Alzheimer's Project Act I authored, we have 
accelerated our understanding of this complex disease and unlocked 
steps we can take to increase early detection and diagnosis, reduce 
risk, prevent avoidable hospitalizations, and support dementia 
caregivers. Groundbreaking research has also now led to a new age of 
treatment, with disease-modifying therapies now available to patients. 
These promising treatments could substantially change how the disease 
is perceived and managed, increasing the urgency to educate the public, 
and promote early diagnosis.
  Now, after decades of increasing investments in biomedical research 
for Alzheimer's, we are nearing the next phase of effectively 
preventing, treating, and curing Alzheimer's--translating research into 
real-world interventions. The BOLD Infrastructure for Alzheimer's Act 
accelerated a multipronged public health approach for the prevention, 
treatment, and care of Alzheimer's and related dementias. The bill we 
are introducing today would reauthorize the BOLD Infrastructure for 
Alzheimer's Act for 5 years in order to ensure that these critical 
activities can continue to reach communities across the country.
  Specifically, the BOLD Infrastructure for Alzheimer's Act directed 
CDC to establish Alzheimer's and Related Dementias Public Health 
Centers of Excellence, provide Federal funding to support State, local, 
and Tribal public health departments, and increase data analysis and 
timely reporting in order to inform interventions, research, and public 
policy.
  The CDC's Centers of Excellence are now working to promote effective 
Alzheimer's disease management and caregiving interventions, as well as 
educating the public on Alzheimer's disease, cognitive decline, and 
brain health. Each center is focused on a key issue related to 
dementia--from risk reduction to early detection to

[[Page S498]]

caregiving. The three current centers have established themselves as 
national resources and are supporting nationwide implementation of the 
actions outlined in the CDC's Healthy Brain Initiative's Road Map. This 
includes identifying, translating, and disseminating promising research 
findings and best practices for nationwide uptake. Our legislation 
would reauthorize the Alzheimer's Disease and Related Dementias Public 
Health Centers of Excellence and add a new focus on implementation 
science, which is essential to bridging the gap between research 
findings and practical application in real-world settings.
  In addition, building upon the CDC's Healthy Brain Initiative and its 
Public Health Road Map, the BOLD Infrastructure for Alzheimer's Act has 
provided public health departments with the funding and support 
necessary to implement effective Alzheimer's interventions in 
communities across the country, including a focus on reducing the risk 
of dementia, increasing early detection and diagnosis, and supporting 
caregivers. Forty-three public health departments across the United 
States are now promoting a strong public health approach to Alzheimer's 
disease and related dementia with the support of BOLD awards.
  In September 2020, the Maine Department of Health and Human Services 
received one of the first BOLD Program Awards. This investment has 
allowed for the implementation of the Maine State Plan for Alzheimer's 
Disease and Related Dementias, as well as advancements in Maine's 
public awareness of brain health, early detection and diagnosis of 
Alzheimer's disease, and access to care and support. Maine's Department 
of Health and Human Services has even been able to publish county-
specific data on cognitive decline to better understand risk factors 
and prevention across the State. In addition, the Bangor Public Health 
& Community Services Department and partners have educated its 
employees on how to respond to the Alzheimer's public health crisis, 
emphasizing early detection and diagnosis and brain health. Efforts 
such as these play a key role in bringing awareness to and ultimately 
reducing the growing prevalence of dementia in the State.
  In September 2023, Maine received a second BOLD award from the CDC 
for Alzheimer's prevention programs. This implementation funding will 
allow Maine to build on its initial investments and carry out the Maine 
Alzheimer's Prevention Program and the CDC's Healthy Brain Initiative 
Road Map.
  There continues to be an urgent need to translate what science tells 
us about the opportunity to reduce risk, delay onset, and ultimately 
reduce prevalence into effective public health practice. However, 
unless Congress acts to reauthorize these effective programs, BOLD 
programming is set to expire on September 30. The BOLD Infrastructure 
for Alzheimer's Reauthorization Act would continue our investment in a 
nationwide Alzheimer's public health response so that States, including 
Maine, can sustain the critical work being done in communities across 
the country and ensure this work has a real-world impact in the years 
ahead.
  As founder and cochair of the Congressional Task Force on Alzheimer's 
Disease, the fight against Alzheimer's for me is both personal and a 
matter of crafting effective public policy. Virtually every family in 
the country has been touched by this disease, and I know the gravity of 
this disease firsthand as I lost my father, grandfather, and two uncles 
to Alzheimer's. I remain committed to advancing research, care, and 
support for individuals and families living with this devastating 
disease. Reauthorization of the BOLD Infrastructure for Alzheimer's Act 
will ensure communities across the country have access to resources to 
promote effective Alzheimer's interventions and better cognitive health 
that can lead to improved health outcomes.
  This bipartisan legislation is endorsed by the Alzheimer's 
Association, the Alzheimer's Impact Movement, and UsAgainstAlzheimer's. 
I urge my colleagues to support this critical legislation.
                                 ______