I 
111TH CONGRESS 
1ST SESSION H. R. 2987 
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 Alz-
heimer’s disease (with particular emphasis on education and outreach 
in Hispanic populations), and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 19, 2009 
Ms. LINDA T. SA´NCHEZ of California (for herself, Ms. BERKLEY, Mr. BISHOP 
of Georgia, Ms. BORDALLO, Mr. BRADY of Pennsylvania, Mr. GRIJALVA, 
Mr. HOLT, Ms. KAPTUR, Ms. LEE of California, Mr. MCGOVERN, Mr. 
NADLER of New York, Mrs. NAPOLITANO, Mr. PAYNE, Mr. PIERLUISI, 
Mr. REYES, Ms. ROS-LEHTINEN, Mr. RYAN of Ohio, Mr. SERRANO, Mr. 
SIRES, Ms. WATERS, Mr. WEXLER, and Mr. WU) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend the Public Health Service Act to ensure sufficient 
resources and increase efforts for research at the Na-
tional Institutes of Health relating to Alzheimer’s dis-
ease, 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. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Cure and Under-
standing through Research for Alzheimer’s Act of 2009’’ 
or the ‘‘La Cura Act of 2009’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) Alzheimer’s disease is the seventh leading 
cause of death of all ages in the United States (and 
the fifth leading cause of death for people over 65 
years of age), with 5.2 million individuals in the 
United States living with Alzheimer’s disease. Cur-
rently, one of each eight individuals in the United 
States over age 65 has Alzheimer’s disease. Every 
71 seconds, an individual in the United States devel-
ops Alzheimer’s disease, and by 2050, every 33 sec-
onds an individual in the United States will develop 
this disease. By 2050, the number of individuals in 
the United States age 65 and over with Alzheimer’s 
disease will range from 11 million to 16 million indi-
viduals. 
(2) The prevalence of Alzheimer’s disease and 
dementia seems to be higher among individuals with 
fewer years of education. Individuals with fewer than 
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12 years of education have a 15 percent greater risk 
of developing dementia than individuals with 12 to 
15 years of education and a 35 percent greater risk 
of developing dementia than individuals with more 
than 15 years of education. 
(3) Hispanics are the fastest growing popu-
lation in the Nation and by 2050, will have a life ex-
pectancy of 87 years, longer than any other ethnic 
or racial group. The Hispanic community in the 
United States is projected to experience a six-fold in-
crease in Alzheimer’s disease (from fewer than 
200,000 to as many as 1.3 million) by 2050. 
(4) Hispanics may be at a greater risk of devel-
oping dementia than other ethnic or racial groups: 
Hispanics’ 64-percent higher incidence of diabetes 
than non-Hispanic White Americans is of particular 
concern in light of new findings that diabetes is the 
one vascular risk factor that, in the absence of 
stroke, is related to an increased risk of Alzheimer’s 
disease. 
(5) Research on disparities in Alzheimer’s risk 
factors between Hispanic and other ethnic and racial 
groups is only beginning to sort out complex dif-
ferences: for example, even in the absence of the 
APOE-e4 allele, the one known genetic risk factor 
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for late onset Alzheimer’s, Caribbean Hispanics have 
a cumulative risk for Alzheimer’s twice that of non- 
Hispanic Whites. 
(6) The shortage of bilingual health profes-
sionals, combined with the large population of 
monolingual Spanish-speaking seniors, makes ade-
quate testing and diagnosis of Alzheimer’s among el-
derly Hispanics difficult and may lead to cultural bi-
ases in cognitive testing. Moreover, inadequate 
translation of diagnostic tools can lead to improper 
diagnoses, and there may be poor understanding of 
recommended treatment and self-care even among 
those who are properly diagnosed. 
(7) Hispanics are far more likely to be unin-
sured than any other ethnic group: the Bureau of 
the Census reports that 34.1 percent of the Hispanic 
population in the United States is uninsured, com-
pared to 10.8 percent for non-Hispanic Whites and 
15.3 percent for all United States residents. 
(8) Lack of access to health care and a strong 
cultural commitment to caring for one’s elders with-
in the family are among the factors that make His-
panics with dementia less likely than non-Hispanics 
to see a physician and use related services provided 
by formal health professionals. Hispanic caregivers 
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surveyed were significantly more likely (33 percent) 
than caregivers of other races (23 percent) to believe 
that Alzheimer’s disease is a normal part of the 
aging process and were also significantly more likely 
(67 percent) to dismiss the symptoms of Alzheimer’s 
disease as old age than other respondents of other 
races (53 percent). Delays in diagnosis and lack of 
early and consistent treatment can lead to higher 
levels of impairment and increased stress on family 
caregivers. 
(9) Hispanic elders are second most likely, after 
Asian-Americans, to live with their families rather 
than in long-term care facilities. More research is 
needed to better understand the effects of differing 
care settings on family caregivers and Alzheimer’s 
patients. 
(10) Alzheimer’s disease costs the United 
States $148 billion each year in direct and indirect 
costs to business, the Medicare program, and the 
Medicaid program (not including private health in-
surance costs). If the prevalence of Alzheimer’s dis-
ease continues to increase as expected, the $91 bil-
lion spent in 2005 on Medicare costs for care of in-
dividuals with Alzheimer’s disease and dementia pa-
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tients is projected to increase to $189 billion by 
2015. 
SEC. 3. NIH RESEARCH AND EDUCATION ON ALZHEIMER’S 
DISEASE. 
Subpart 5 of part C of title IV of the Public Health 
Service Act (42 U.S.C. 285e et seq.) is amended by adding 
at the end the following new section: 
‘‘SEC. 445J. NIH RESEARCH AND EDUCATION ON ALZ-
HEIMER’S DISEASE. 
‘‘(a) RESEARCH
ACTIVITIES.—In conducting re-
search relating to Alzheimer’s disease, the Director of the 
National Institutes of Health shall ensure sufficient re-
sources for activities relating to Alzheimer’s disease and 
Hispanic communities, including by— 
‘‘(1) increasing efforts in epidemiological work 
in Hispanic subgroups; 
‘‘(2) allocating resources to the National Insti-
tute on Aging Alzheimer’s disease research centers 
and other academic centers involved in Alzheimer’s 
disease research to increase participation of His-
panics and other underrepresented ethnic groups in 
research and clinical trials in sufficient numbers to 
draw valid conclusions; and 
‘‘(3) conducting social, behavioral, and health 
services research— 
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‘‘(A) to understand more fully the under-
lying reasons that Hispanic individuals delay di-
agnosis and underutilize services; 
‘‘(B) to identify culturally and linguis-
tically appropriate approaches for addressing 
such delays and underutilization; and 
‘‘(C) to identify approaches for providing, 
and improving the quality of, culturally com-
petent care. 
‘‘(b) EDUCATION ACTIVITIES.—The Director of the 
National Institutes of Health shall expand and intensify 
efforts of the National Institutes of Health— 
‘‘(1) to educate communities about the impor-
tance of research relating to Alzheimer’s disease; 
and 
‘‘(2) to respond effectively to cultural concerns 
about participation in such research, especially with 
respect to sensitive matters like the collection of 
brain tissue and genetic information.’’. 
SEC. 4. INCREASED FUNDING FOR ALZHEIMER’S DISEASE 
DEMONSTRATION GRANTS. 
Section 398B(e) of the Public Health Service Act (42 
U.S.C. 280c–5(e)) is amended— 
(1) by striking ‘‘and such’’ and inserting 
‘‘such’’; and 
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(2) by inserting before the period at the end ‘‘, 
$25,000,000 for fiscal year 2010, and such sums as 
may be necessary for each of the fiscal years 2011 
through 2014’’. 
SEC. 5. CDC OUTREACH AND EDUCATION. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317T the following: 
‘‘SEC. 317U. EDUCATION AND OUTREACH ON ALZHEIMER’S 
DISEASE. 
‘‘(a) PURPOSES.—The purposes of this section are 
the following: 
‘‘(1) To reduce the risk of Alzheimer’s disease 
through reduction of vascular risk factors. 
‘‘(2) To encourage early recognition and diag-
nosis of dementia. 
‘‘(3) To train public health personnel to recog-
nize, assess, diagnose, and treat Alzheimer’s disease 
in ways that are culturally appropriate and sup-
portive of families. 
‘‘(b) EDUCATION AND OUTREACH.—To achieve the 
purposes of this section, the Secretary, acting through the 
Centers for Disease Control and Prevention, shall conduct 
an aggressive, evidence-based education and outreach pro-
gram to promote public awareness and risk reduction with 
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respect to Alzheimer’s disease. In conducting the outreach 
program, the Secretary shall consult with State Health 
Departments and may consult with other appropriate enti-
ties, including the Alzheimer’s Association and the Alz-
heimer’s Foundation of America. 
‘‘(c) EMPHASIS.—In carrying out this section, the 
Secretary shall give particular emphasis to education and 
outreach in Hispanic populations.’’. 
Æ 
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