A National Dementia Plan With No Results: A Call for Real Accountability

We Have a Framework, But No Progress

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 grappling with a crisis that governments still treat as a distant concern. In my view, America already possesses a comprehensive national plan, yet we continue to fall short of the results our communities desperately need.

The Department of Health and Human Services' National Plan to Address Alzheimer's disease outlines clear goals spanning research, treatment, care, family support, public awareness, data collection, and risk reduction. Despite this detailed strategy, what we lack is implementation—specifically, accountability that translates intentions into outcomes.

"We know dementia matters. Families plainly deserve to know who owns each goal, how success will be measured, and when results are due."

The Public Law 118-92 extended the National Alzheimer's Project through 2035, indicating a strong commitment from Congress. Yet, the Government Accountability Office found in June 2026 that the Department of Health and Human Services still needed near-term goals with numerical targets, deadlines, and clearer progress reporting.

Three Pillars for Real Change

I believe an effective strategy must connect three priorities: reducing risk, supporting care, and advancing treatment. Treating them as separate agendas weakens 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.

Prevention also requires precision. The World Health Organization's 2026 dementia-risk guidelines report 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.

This statistic should not be used to blame individuals for developing dementia; rather, it is a mandate for public policy that helps more people manage preventable risks throughout their lives. HHS must convert this guidance into defined national targets and report annually on progress. It's time we move beyond promises and toward performance.

The Crisis of Caregiving

Another area that demands equal attention is caregiving. The Alzheimer's Association estimates that nearly 13 million Americans provide unpaid dementia care—often at great personal cost. These family caregivers bear a burden that no policy should ignore.

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: 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, but rather a disciplined system that learns, adjusts, and reports honestly—ensuring that no family feels alone in their struggle.

A Call for Immediate Accountability

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 must have an accountable agency, annual funding disclosure, numerical performance target, and deadline. Results should be reported to Congress and the public each year.

Prevention, caregiving, and treatment must 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. Our country has the tools to act, but more importantly, it has the responsibility to do so.

In the end, what matters most is not just having a plan, but ensuring that it is followed through with real commitment and measurable impact. That's what our families deserve—and that's what we must deliver.