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By Paul Shemella
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When the World Health Organization reports that more than 57 million people live with dementia and nearly 10 million new cases emerge each year, I do not see an abstract statistic. I see families absorbing a crisis that governments still treat as a distant concern.
In the United States, the Alzheimer’s Association estimates that 7.4 million Americans have Alzheimer’s and predicts dementia care will cost $409 billion in 2026 and nearly $1 trillion annually by 2050. Waiting for that future is not a strategy, in my view.
What frustrates me is that America already has a framework for a coordinated response. The Department of Health and Human Services’ National Plan to Address Alzheimer’s disease establishes goals spanning research, treatment, care, family support, public awareness, data, and risk reduction.
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In 2024, Public Law 118-92 extended the National Alzheimer’s Project through 2035. It seems to me our failure is therefore not a lack of ideas or authority. It is accepting broad commitments without demanding measurable results.
The Government Accountability Office reinforced my concern in June 2026. It found that the Department of Health and Human Services still needed near-term goals with numerical targets, deadlines, and clearer progress reporting. You would have thought that finding should end the era of reassuring declarations. We know dementia matters. Families plainly deserve to know who owns each goal, how success will be measured, and when results are due.
We Need An Effective Strategy
I believe an effective strategy must connect three priorities: reducing risk, supporting care, and advancing treatment. Treating them as separate agendas must weaken all three.
Earlier detection risks being wasted if families cannot navigate care. Scientific progress will potentially reach too few people if there is a lag between diagnostic capacity and treatment access. Risk-reduction advice would surely remain unequal if communities lack access to health care, safe places for physical activity, or help managing conditions such as high blood pressure and diabetes.
It seems obvious that prevention also requires more precision. In its 2026 dementia-risk guidelines, the World Health Organization reported that up to 45 percent of dementia risk may be associated with modifiable factors, including tobacco and alcohol use, physical inactivity, social isolation, air pollution, high blood pressure, and diabetes.
I do not interpret that figure as a reason to blame individuals for developing dementia. No one can eliminate the influence of age, genetics, or other factors. I see it as a mandate for public policy that helps more people manage preventable risks throughout their lives. HHS should convert that guidance into defined national targets and report annually on progress.
Caregiving Is Key
Another area that needs equal attention in my experience is caregiving. The same Alzheimer’s Association’s 2026 report estimates that nearly 13 million Americans provide unpaid dementia care.
The Centers for Medicare & Medicaid Services’ GUIDE Model is intended to show how federal policy can support families beyond clinical treatment. CMS says the program includes care navigation, caregiver education, round-the-clock assistance, and respite services for qualifying caregivers. I see it as a useful test, but not a complete answer. Its results should determine whether those services deserve wider Medicare coverage.
The consequences of inaction are visible to me: more exhausted families, deeper inequities and rising costs without a clear account of what public spending achieves. The alternative is not a promise to eliminate dementia on a political timetable. It is a disciplined system that learns, adjusts and reports honestly.
My One-year Deadline
Within the next 12 months, the HHS secretary should implement the GAO recommendations by publishing a five-year dementia action scorecard.
Every National Plan goal should have an accountable agency, annual funding disclosure, numerical performance target, and deadline, with results reported to Congress and the public each year. Prevention, caregiving, and treatment should appear on the same scorecard because families experience them as one crisis.
Dementia may not yet have a cure, but a national response without deadlines is one failure we already know how to prevent.
Paul Shemella is the author of Into the Mist: An Alzheimer’s Journey, a memoir chronicling his wife’s experience with Alzheimer’s disease. The views expressed in this article are his own.
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