P4‐444: Emergency Preparedness Planning for People Living with Dementia: a Comparison of County Level Demographic Characteristics with Recent Dementia Prevalence Estimates in California Counties

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Alzheimer's & Dementia

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The Healthy Brain Initiative: The Public Health Road Map for State and National Partnerships was recently updated for years 2018‐2022, which includes recommendations for implementing emergency preparedness (EP) measures at the state and local levels with attention to the unique needs of people living with Alzheimer's disease and other related dementias (ADRD). The potential catastrophic impact of a natural disaster on this population is high. Yet, implementing effective strategies may be complicated by the needs of individuals at different stages of the disease.


We utilized published data from 2015 on demographic characteristics of adults over 65 years of age in California from the American Community Survey (ACS). The ACS is a national survey that uses continuous measurement methods to produce annually updated estimates. We used 2015 ADRD prevalence data from estimated county level prevalence rates reported in the 2017 Alzheimer's Association's California Facts and Figures County Data Report. We compared ADRD prevalence rates with county demographic characteristics, age, ethnicity, income, and living status.


We mapped California county level ADRD prevalence estimates to county level demographic characteristics for California counties from the ACS. We found both the three counties with the highest level of ADRD prevalence and population of adults aged 65 years and older were Los Angeles, Orange, and San Diego – also the three most populous California counties overall. However, the three counties with the highest levels of non‐institutionalized adults aged 65 years and older were Imperial, Merced, and Lake. County poverty level rates for adults aged 65 years and older ranged from a high of 17.7% in Imperial to 4.2% in Calaveras.


We found variation in the prevalence of dementia by county and in several measures of potential vulnerability. The frequency of natural disasters and the increasing prevalence of individuals living with dementia suggest a need to better prepare for the needs of this population. More research is needed on how local public health departments are implementing the EP recommendations from the Public Health Road Map across various localities as well as how to appropriately address the varying needs of individuals at different stages of the disease process.


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