107th Congress

Alzheimer's Disease Research, Prevention, and Care Act of 2002

H.R. 4606 and S. 2059

Background

Alzheimer's disease (AD) is the most common form of dementia among older people. It involves the parts of the brain that control thought, memory, and language. The causes of AD are still unknown, and there is no cure. Scientists think that up to 4 million Americans suffer from AD. The disease usually begins after age 60, and risk increases with age. While younger people may also get AD, it is much less common. About 3 percent of men and women ages 65 to 74 have AD, and nearly half of those age 85 and older may have the disease. It is important to note, however, that AD is not a normal part of aging.

Senator Barbara A. Mikulski (D-MD), the sponsor of S. 2059, has been a major supporter of AD research, in part because her father suffered from the disease. When she introduced S. 2059 on March 21, 2002, she stated that Alzheimer's disease will take an even greater toll as the baby-boom generation ages. She stated that, "Unless science finds a way to prevent or cure Alzheimer's disease, 14 million people in the United States will have Alzheimer's disease by the year 2050. The race to find a cure is more urgent than ever."

Representative Edward J. Markey (D-MA), the sponsor of H.R. 4606, is very involved with AD issues. In June 1999, the year his mother died from the disease, he created the Bipartisan Congressional Task Force on Alzheimer's Disease, along with Representative Christopher H. Smith (R-NJ), to raise awareness among Members of Congress.

Provisions of the Legislation/Impact on NIH

Section 3 of S. 2059 would have amended the National Institute on Aging's (NIA) statute to require that AD research be a priority for the Institute. H.R. 4606 would have added AD research to the purpose clause of NIA.

Section 4 of S. 2059 and H.R. 4606 would have authorized NIA to award AD research training grants. It also would have put in statute NIA's existing Alzheimer's Disease Prevention Initiative to 1) accelerate the discovery of new risk and protective factors for AD, 2) rapidly identify candidate diagnostics, therapies, or preventive interventions or agents for clinical investigation and trials relating to AD, 3) support or undertake such investigations and trials, and 4) implement effective prevention and treatment strategies, including strategies to improve patient care and alleviate caregiver burdens relating to AD.

Section 5 of S. 2059 and H.R. 4606 would have deleted the authorizing language for the Dissemination Project and replaced it with language regarding AD clinical research. AD information dissemination, which does not need statutory authority, would have continued through the AD Education and Referral Center and the AD Research Centers. The new clinical research section of S. 2059 and H.R. 4606 would have put in statute NIA's current AD cooperative study group, referred to in the bill as "cooperative clinical research regarding Alzheimer's disease." This section would have put in statute a requirement that NIA conduct or award grants for research related to the early detection and diagnosis of AD and the relationship of vascular disease and AD. Authority to establish a National Alzheimer's Coordinating Center to facilitate collaborative research among the AD Centers and AD Research Centers would have been added to the statute. This section would have also added "outcome measures and disease management" to the AD Center authority.

Section 6 of S. 2059 and H.R. 4606 would have deleted obsolete language pertaining to a report that was submitted to the Council on Alzheimer's Disease in the late 1980s. This section would have also added a requirement to the statute directing NIA to award grants for research to help caregivers of patients with AD and related disorders and to improve patient outcomes. This provision was similar to NIA's Resources for Enhancing Alzheimer Caregiver Health (REACH) program, a large-scale, coordinated study to examine the effectiveness of social, behavioral, environmental, and technological interventions for reducing the burden of caring for people with dementia.

Section 7 of S. 2059 would have reauthorized NIA appropriations at $1.1 billion for fiscal year (FY) 2003, $1.2 billion for FY 2004, $1.3 billion for FY 2005, $1.4 billion for FY 2006, and $1.5 billion for FY 2007. H.R. 4606 would have authorized $1.5 billion for FY 2003 and such sums as may be necessary for each of the FYs 2004 through 2007.

Section 8 of S. 2059 would have reauthorized the Alzheimer's Disease Prevention Grants for $20 million for FY 2003 and such sums as may be necessary for each of the FYs 2004 through 2007. H.R. 4606 would have authorized $25 million for FY 2003 and such sums as may be necessary for each of the FYs 2004 through 2007.

Status and Outlook

S. 2059 was introduced on March 21, 2002, and referred to the Senate Health, Education, Labor and Pensions Committee. On June 26, the Committee marked up the bill and ordered it to be reported with an amendment in the nature of a substitute. On July 3, the bill was reported (no written report was issued) and placed on the Senate Legislative Calendar under General Orders.

H.R. 4606 was introduced on April 25, 2002, and referred to the House Energy and Commerce Committee.

Although there was no further action on this legislation during the 107th Congress, it is anticipated that similar legislation will be introduced in the 108th Congress.