APA responds to first draft of National Framework for Alzheimer’s Disease

Comments emphasize psychologists' contributions to Alzheimer’s research, assessment, diagnosis, and treatment.

By Pat Kobor

With input from members of the American Psychological Association’s Division 20 (Adult Development & Aging), Division 40 (Clinical Neuropsychology), and Committee on Aging, APA has submitted detailed comments (PDF, 317KB) on the first draft of a federal plan of action to reduce the burdens of Alzheimer’s Disease (AD) entitled the National Framework for Alzheimer’s Disease (PDF, 110KB).

The Framework was authorized in legislation passed in 2011 called the National Alzheimer’s Project Act (PDF, 119KB).  The legislation also established the Advisory Council on Alzheimer's Research, Care, and Services.  Neuropsychologist and APA member Jennifer Manly, of Columbia University, was appointed to this Council and serves as chair of its Research Subcommittee.

The draft Framework was developed primarily by staff in the U.S. Department of Health and Human Services, which houses the initiative.  Both federal and nonfederal members of the Advisory Council commented on the Framework and discussed strategies to meet the plan’s goals at a meeting in Washington DC on January 17-18, 2012. The Framework will be revised in response to comments.

The draft Framework is structured around five goals:

  • Prevent and Effectively Treat Alzheimer's Disease by 2025 

  • Optimize Care Quality and Efficiency 

  • Expand Patient and Family Support 

  • Enhance Public Awareness and Engagement 

  • Track Progress and Drive Improvement

APA’s comments, presented by Chief Executive Officer Norman Anderson, noted that neither the word “psychology” nor “neuropsychology” appeared in the draft document—an oversight that must be corrected -- and emphasized the need for additional behavioral and cognitive research to be conducted along with research to identify biomarkers:

“While the draft plan emphasizes the need to expand research on molecular and cellular mechanisms and genetics research to identify risk and protective factors, a research agenda that neglects the critical behavioral and social aspects of AD would be unsuccessful and insufficient…While the increased ability for scientists to monitor changes in biomarkers is certainly promising, psychologists and others are concerned that there is considerable heterogeneity in how pathogenic factors in AD are related to the symptoms of the disease.  There is strong evidence that some neuropsychological measures can more sensitively predict conversion to Alzheimer’s than most biomarkers (Gomar, et al, 2011; Heister, et al, 2011; Landau, et al, 2010).”

APA’s comments also emphasized the need for the Plan to acknowledge and encourage the delivery of care by multidisciplinary teams, and pointed out ways in which Medicare coverage makes it difficult for professional psychologists to assist family members in their roles as caregivers. For example, Medicare does not reimburse for meetings with family members for planning or therapeutic purposes if the person with AD is not present.

APA staff will continue to track and contribute to federal policy development surrounding Alzheimer’s Disease.

Deborah DiGilio, director of APA’s Office on Aging, and Pat Kobor, who covers aging research for the APA Science Directorate’s Government Relations Office, worked jointly to help prepare APA’s comments.