II 

110TH CONGRESS 

2D SESSION S. 3092 

To amend the Public Health Service Act to ensure sufficient resources and 

increase efforts for research at the National Institutes of Health relating 

to Alzheimer’s disease, to authorize an education and outreach program 

to promote public awareness and risk reduction with respect to Alzheimer’s disease (with particular emphasis on education and outreach 

in Hispanic populations), and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 5, 2008 

Mr. MENENDEZ (for himself and Ms. MIKULSKI) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to ensure sufficient 

resources and increase efforts for research at the National Institutes of Health relating to Alzheimer’s disease, to authorize an education and outreach program 

to promote public awareness and risk reduction with 

respect to Alzheimer’s disease (with particular emphasis 

on education and outreach in Hispanic populations), and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Cure and Under3 standing through Research for Alzheimer’s Act of 2008’’, 

4 or the ‘‘CURA Act of 2008’’. 

5 SEC. 2. FINDINGS. 

6 Congress makes the following findings: 

7 (1) The incidence and prevalence of Alzheimer’s 

8 disease increase with age. Alzheimer’s disease is cur9 rently the 7th leading cause of death of all ages in 

10 the United States (number 5 for people over 65 

11 years of age), with 5,200,000 Americans living with 

12 Alzheimer’s. Currently, 1 in 8 Americans over age 

13 65 has Alzheimer’s. Every 71 seconds, someone de14 velops Alzheimer’s disease, and by 2050, someone 

15 will develop this disease every 33 seconds. By 2050, 

16 the number of individuals age 65 and over with Alz17 heimer’s will range from 11,000,000 to 16,000,000 

18 people. It is projected that by 2050, more than 60 

19 percent of people with Alzheimer’s disease will be 

20 age 85 or older. 

21 (2) The prevalence of Alzheimer’s disease and 

22 dementia seem to be higher among people with fewer 

23 years of education. People with less than 12 years 

24 of education have a 15 percent greater risk of devel25 oping dementia than people with 12 to 15 years of 

26 education and a 35 percent greater risk of develVerDate Aug 31 2005 22:38 Jun 07, 2008 Jkt 069200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3092.IS S3092

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1 oping dementia than people with more than 15 years 

2 of education. 

3 (3) Hispanics are the fastest growing popu4 lation in the United States and by 2050 will have a 

5 life expectancy of 87 years, longer than any other 

6 ethnic or racial group. The Hispanic community in 

7 the United States is projected to experience a six8 fold increase in Alzheimer’s disease (from fewer than 

9 200,000 to as many as 1,300,000) by 2050. 

10 (4) Hispanics may be at a greater risk of devel11 oping dementia than other ethnic or racial groups. 

12 Hispanics have a 64 percent higher incidence of dia13 betes than non-Hispanic white Americans, and this 

14 is of particular concern in light of new findings that 

15 diabetes is the one vascular risk factor that, in the 

16 absence of stroke, is related to an increased risk of 

17 Alzheimer’s disease. 

18 (5) Research on disparities in Alzheimer’s risk 

19 factors between Hispanic and other ethnic and racial 

20 groups is only beginning to sort out complex dif21 ferences. For example, even in the absence of the 

22 APOE-e4 allele, the one known genetic risk factor 

23 for late onset Alzheimer’s, Caribbean Hispanics have 

24 a cumulative risk for Alzheimer’s twice that of non25 Hispanic whites. 


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1 (6) The shortage of bilingual health profes2 sionals, combined with the large population of 

3 monolingual Spanish-speaking seniors, makes ade4 quate testing and diagnosis of Alzheimer’s among el5 derly Hispanics difficult and may lead to cultural bi6 ases in cognitive testing. Moreover, inadequate 

7 translation of diagnostic tools can lead to improper 

8 diagnoses, and there may be poor understanding of 

9 recommended treatment and self-care even among 

10 those who are properly diagnosed. 

11 (7) Hispanics are far more likely to be unin12 sured than any other ethnic group. The Census Bu13 reau reports that 34.1 percent of Hispanics in the 

14 United States are uninsured, compared to 10.8 per15 cent for non-Hispanic whites and 15.3 percent for 

16 all United States residents. 

17 (8) Lack of access to healthcare and a strong 

18 cultural commitment to caring for one’s elders with19 in the family are among the factors that make His20 panics with dementia less likely than non-Hispanics 

21 to see a physician and use related services provided 

22 by formal health professionals. Delays in diagnosis 

23 and lack of early and consistent treatment can lead 

24 to higher levels of impairment and increased stress 

25 on family caregivers. 


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1 (9) Hispanic elders are second most likely, after 

2 Asian-Americans, to live with their families rather 

3 than in long term care facilities. More research is 

4 needed to better understand the effects of differing 

5 care settings on family caregivers and Alzheimer’s 

6 patients. 

7 (10) Alzheimer’s disease costs the United 

8 States $148,000,000,000 a year in direct and indi9 rect costs to business, Medicare, and Medicaid (not 

10 including private insurance). 

11 SEC. 3. NIH RESEARCH AND EDUCATION ON ALZHEIMER’S 

12 DISEASE. 

13 (a) RESEARCH ACTIVITIES.—In conducting research 

14 relating to Alzheimer’s disease, the Director of the Na15 tional Institutes of Health shall ensure sufficient resources 

16 for activities relating to Alzheimer’s disease and Hispanic 

17 communities, including by— 

18 (1) increasing efforts in epidemiological work in 

19 Hispanic subgroups; 

20 (2) allocating resources to the National Insti21 tute on Aging Alzheimer’s disease research centers, 

22 and other academic centers involved in Alzheimer’s 

23 disease research, to increase participation of His24 panics and other underrepresented ethnic groups in 


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1 research and clinical trials in sufficient numbers to 

2 draw valid conclusions; and 

3 (3) conducting social, behavioral, and health 

4 services research— 

5 (A) to understand more fully the under6 lying reasons that Hispanic individuals delay di7 agnosis and underutilize services; 

8 (B) to identify culturally and linguistically 

9 appropriate approaches for addressing such 

10 delays and underutilization; and 

11 (C) to identify what is culturally competent 

12 care. 

13 (b) EDUCATION ACTIVITIES.—The Director of the 

14 National Institutes of Health shall expand and intensify 

15 the efforts of the Institutes— 

16 (1) to educate communities about the impor17 tance of research relating to Alzheimer’s disease; 

18 and 

19 (2) to respond effectively to cultural concerns 

20 about participation in such research, especially with 

21 respect to sensitive matters like the collection of 

22 brain tissue and genetic information. 


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1 SEC. 4. INCREASED FUNDING FOR ALZHEIMER’S DISEASE 

2 DEMONSTRATION GRANTS. 

3 Section 398B(e) of the Public Health Service Act (42 

4 U.S.C. 280c–5(e)) is amended— 

5 (1) by striking ‘‘and such’’ and inserting 

6 ‘‘such’’; and 

7 (2) by inserting before the period the following: 

8 ‘‘, $25,000,000 for fiscal year 2009, and such sums 

9 as may be necessary for each of fiscal years 2010 

10 through 2013’’. 

11 SEC. 5. CDC OUTREACH AND EDUCATION. 

12 Part B of title III of the Public Health Service Act 

13 (42 U.S.C. 243 et seq.) is amended by inserting after sec14 tion 317S the following: 

15 ‘‘SEC. 317T. EDUCATION AND OUTREACH ON ALZHEIMER’S 

16 DISEASE. 

17 ‘‘(a) PURPOSES.—The purposes of this section are 

18 the following: 

19 ‘‘(1) To reduce the risk of Alzheimer’s disease 

20 through the reduction of vascular risk factors. 

21 ‘‘(2) To encourage the early recognition and di22 agnosis of dementia. 

23 ‘‘(3) To train public health personnel to recog24 nize, assess, diagnose, and treat Alzheimer’s disease 

25 in ways that are culturally appropriate and sup26 portive of families. 


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1 ‘‘(b) EDUCATION AND OUTREACH.—To achieve the 

2 purposes of this section, the Secretary, acting through the 

3 Centers for Disease Control and Prevention, shall conduct 

4 an aggressive, evidence-based education and outreach pro5 gram to promote public awareness and risk reduction with 

6 respect to Alzheimer’s disease. In conducting the outreach 

7 program, the Secretary shall consult with State health de8 partments and other appropriate entities, including the 

9 Alzheimer’s Association. 

10 ‘‘(c) EMPHASIS.—In carrying out this section, the 

11 Secretary shall give particular emphasis to education and 

12 outreach in Hispanic populations.’’. 

Æ 


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