Thirteen years ago, the National Alzheimer’s Project Act (NAPA) was signed into law to tackle the growing challenge of Alzheimer’s disease and dementia nationwide. In October 2024, the NAPA Reauthorization Act extended this effort through 2035, ensuring continued support for this important work. The NAPA plan fiscal year update released in December 2024 details the progress made through various federal government programs and departments, including the Indian Health Service (IHS). The IHS Alzheimer’s Program has played a major role, celebrating many accomplishments last year.

As part of the report, the IHS Alzheimer’s Program focused on four priorities identified during previous tribal consultation and urban confer. These areas include developing local models of comprehensive dementia care, training healthcare workers, spreading awareness, and strengthening data and program resources. The following is a summary of IHS-highlighted efforts designed to contribute to the federal priority of preventing and treating Alzheimer's disease and related dementias.

Improving Dementia Care in Local Communities

The Dementia Models of Care grants supported 12 two-year tribal and urban Indian recipients serving over 60,000 adults aged 55 and older. These programs help improve dementia screening and care while developing and tailoring services to local needs. In addition, six 2024 recipients were awarded three years of funding for work on program expansion. This effort includes extensive training and technical assistance.

(Pictured are Valerie Jones, Elder Health Care Data Coordinator, Cherokee Nation Health Services Patient Experience Manager Jessica Lewandowski, and Management Analyst Jamie Olsen during a site visit with Cherokee Nation.)

Innovative Training Initiatives

The Alzheimer’s Program initiated a set of education and training efforts tied directly to the development of services and improvement in care for older individuals and those living with dementia and their caregivers. These efforts build on and leverage our federal partners' significant provider training and education investments. Most education and training efforts aim to pair didactic education with local system-level improvement in recognition, diagnosis, assessment, and care management to achieve meaningful and sustainable change. Major accomplishments include:

• The award of a multi-year contract for discipline-specific dementia training, education, and support for workforce development programs. 

• A new Community Health Representative (CHR) Early Dementia Detection Initiative pilot to evaluate the feasibility of CHRs doing cognitive screenings using the Mini-Cog® that included six pilot sites in 2024 and 20 pilot site applicants for 2025.

• The new Geriatric Nurse Fellowship pilot program launched in 2024 funded 15 nurses in various roles in IHS, tribal, and urban Indian Organization health programs for training and local project activities.

• Continuing the Indian Health GeriScholars pilot that, in the first two years, included providers and pharmacists at 28 sites who completed projects focused on detecting and diagnosing dementia, medication safety, fall prevention, and other locally relevant topics. 

• Continuing the ECHO program with the Northwest Portland Area Indian Health Board, with two series that reached more than 700 participants in 10 months from 27 states and all IHS areas. 

Raising Awareness and Sharing Resources

Active development and maintenance of a communications infrastructure to support tribal and urban Indian leadership priorities continue to be a major focus of the IHS Alzheimer’s Program. This includes work to raise awareness and empower local communities. Significant activities in fiscal year 2024 include:

• Photoshoots producing more than 400 photos of American Indian and Alaska Native people and staff from four different states

• Developing a four-part video training series on the Mini-Cog© screening tool

• Publishing 15 biweekly newsletters

• Distributing 35 social media messages, reaching 84,000+ IHS followers 

• Hosting a tribal capacity-building webinar series to increase awareness of funding opportunities and promote existing models of care, reaching 250 people from 64 tribes

• Routinely sharing resources, tools, and training developed by federal and private partners to an active Elder Care listserv

Help for Caregivers

In 2024, the Alzheimer’s Team launched a workgroup to strengthen caregiver services and support. The workgroup, made up of staff from IHS, tribes, and urban Indian facilities, reviewed existing evidence-based interventions for caregivers, identified culturally relevant elements of existing caregiver “coach” systems and supports and developed suggestions to improve local care delivery systems for caregivers of people living with dementia. 

These highlights from the annual NAPA Plan Update, written in mid-2024, reflect only some of the IHS program team's ongoing and planned activities and initiatives. Click to read the full report, or visit our website to learn more about how you can get involved.

​​​​​​The Indian Health Service (IHS) Alzheimer’s and Community Health Representative (CHR) Programs brought together 40 participants, including staff from 20 tribal and urban Indian pilot sites, for a successful CHR Mini-Cog© Screening Pilot Cohort 2 launch meeting. The event was held January 14-16, 2025, at the Phoenix Area Indian Health Service office. 

The three-day training, conducted in partnership with the Oklahoma University Health Sciences Center’s OK Dementia Care Network, covered:

• The basics of dementia 

• CHR roles and competencies in addressing dementia

• Train-the-trainer activities

• Mini-Cog© skill training and practice

• Tips for engaging clinical systems and providers for referral and education

• Local program work planning activities

This pilot aims to improve dementia care and raise awareness about Alzheimer’s and other dementias in American Indian and Alaska Native communities. 

Visit the CHR Website for more information on the Mini-Cog© screening pilot. To watch Mini-Cog© training videos, visit the IHS Alzheimer’s Program website.