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A state amendment addressing rising rates of dementia in Texas passed with overwhelming approval from voters last week, a key victory for Alzheimer’s advocates and the millions of Texans suffering from the disease.

Sixty-nine percent of voters cast their ballots in favor of Proposition 14, marking the end of a years-long effort to create the Dementia Prevention Research Institute of Texas, or DPRIT — a fund that will provide $3 billion in research grants to medical and educational institutions over the next decade.

State Rep. Tom Craddick, a West Texas Republican who co-sponsored a bill to enable the DPRIT vote, called the news a major step “toward protecting future generations.”

“Yesterday, Texans overwhelmingly approved [DPRIT]. Over two million Texans affirmed we need to find the key to prevention and curing dementia, Alzheimer’s and Parkinson’s disease. These diseases touch nearly every family in our state, leaving lasting impacts on loved ones and communities alike,” Craddick said in an emailed statement to Public Health Watch on November 5. “With this vote, Texas has taken a major step toward protecting future generations. … Texans deserve quality health-care research right here at home and I am proud to have carried this legislation.”

In June, State Sen. Joan Huffman, a Republican from Houston who co-authored the bill to create DPRIT, told Public Health Watch that the institute will be modeled after the $6 billion Cancer Prevention Research Institute of Texas, which has made the state the second-largest public funder of cancer research. The goal, she said, is to do for dementia what the state has done for cancer since 2007: invest in groundbreaking research unlike any other state in the nation. 

Huffman said DPRIT will accelerate research that attracts top talent and creates high-quality jobs, “but most importantly, [it will] improve the health and quality of life for Texans impacted by dementia and related disorders.”

The dementia fund’s approval comes at a critical moment for Texas, which ranks second in the nation in Alzheimer’s deaths and third in the disease’s prevalence. The need for intervention is especially high in the Rio Grande Valley — a four-county region along the Texas-Mexico border that’s become the epicenter of a nationwide Alzheimer’s spike.

As Public Health Watch has reported over the past two years, the Valley is also ground zero for an Alzheimer’s surge among Latinos. One in four people over 65 has Alzheimer’s in Starr County, the heart of the Valley’s dementia surge. Seniors there are three times more likely to develop the disease than the national average. Two of the Valley’s four counties, including Starr, don’t have public health departments. The region has no public hospitals and lacks community and senior centers. Roughly half of its residents live in food deserts and one in four households lives in poverty.

Dr. Gladys Maestre, director of the University of Texas at Rio Grande Valley’s Alzheimer’s Disease Resource Center for Minority Aging Research, said Latino residents in the Valley are particularly vulnerable to the disease for a variety of reasons, including lack of education, air pollution, high uninsured rates and other social and environmental factors. 

Maestre emerged as one of the leading Alzheimer’s advocates for the Valley during last spring’s legislative session. She met with Lt. Gov. Dan Patrick, the Republican leader of the Texas Senate, and spoke to every lawmaker from the Rio Grande Valley. Texans suffering from Alzheimer’s, especially those in the chronically underserved Rio Grande Valley, need their government to step up, she told them. 

Now that DPRIT has been created, it will receive taxpayer funds from the state’s $24 billion budget surplus. Before any research grants can be awarded, Texas’ top leaders — Republicans Gov. Greg Abbott, Lt. Gov. Patrick and House Speaker Dustin Burrows  — must first appoint nine members to the institute’s oversight committee. According to the Texas Legislature’s bill analysis, the committee will be made up of members from across Texas, from doctors and researchers to caregivers. Once DPRIT is fully staffed, it will begin fielding grant proposals and can award up to $300 million in government funds each year. 

Despite these developments, questions remain about how these research funds will be distributed and who will receive them. The Rio Grande Valley has been historically underserved and underfunded by the Texas government, leaving some to wonder if the same pattern will play out with DRPIT. That’s a major concern for experts like Maestre, who believes the Rio Grande Valley should be a top priority. 

“A lot of what’s been done is to understand what’s going on, but I want to provide solutions,” Maestre said. “We really need to think very seriously about what we’re going to do to bring these benefits to the Valley and to other areas of Texas.”

Maestre’s biggest concern is that DPRIT’s creation does nothing to provide direct support to Alzheimer’s patients and their caregivers, many of whom are family members. Over the past two years, Texas has only allocated a total of $5.5 million to dementia care and support, despite having a budget surplus in the tens of millions. That’s a strikingly low investment compared to other states facing Alzheimer’s crises. Florida spends $80 million on the disease annually. New York spends $33 million. Even Georgia, a state with less than half as many dementia cases as Texas, spends $10 million a year. And, unlike Texas, these states invest heavily in direct services for Alzheimer’s patients and their families, including training and respite programs for caregivers.

State Sen. Juan “Chuy” Hinojosa, a Democrat who represents the Valley’s Hidalgo County, told Public Health Watch that while DPRIT’s creation is a positive step, it’s just the first of many that need to be taken.

“People are more worried about dementia than they are now about cancer,” Hinojosa said. “Are we funding enough to help and assist local groups to provide support and funding? No. But it is a process that we’ll work through to continue finding ways to increase funding from the state.” 

Many caregivers can’t afford to wait. Maria Alanis, who lives in Brownsville, spent the last seven years watching over her mother, Isabel. Witnessing her mother’s decline from dementia was painful, Alanis told Public Health Watch, but it was the state’s lack of support that really made life difficult. Despite being her mother’s full-time caregiver, Alanis didn’t receive any state benefits.

Isabel died on October 24 at the age of 87. While Alanis misses picking flowers and sitting in the front yard, as her mother loved to do, she doesn’t have time to dwell on what she lost. Not yet, at least. Right now, she’s focused on finding a job to pay off the years of debt she accumulated while caring for her mother.

“Those of us who care for our parents don’t get help,” Alanis said. “It’s too late because we couldn’t give them a better quality of life. And that hurts so much.”