Alzheimer's Association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting

Cyndy B. Cordell, Soo Borson, Malaz Boustani, Joshua Chodosh, David Reuben, Joe Verghese, William Thies, Leslie B. Fried

Research output: Contribution to journalReview articlepeer-review

248 Scopus citations

Abstract

The Patient Protection and Affordable Care Act added a new Medicare benefit, the Annual Wellness Visit (AWV), effective January 1, 2011. The AWV requires an assessment to detect cognitive impairment. The Centers for Medicare and Medicaid Services (CMS) elected not to recommend a specific assessment tool because there is no single, universally accepted screen that satisfies all needs in the detection of cognitive impairment. To provide primary care physicians with guidance on cognitive assessment during the AWV, and when referral or further testing is needed, the Alzheimer's Association convened a group of experts to develop recommendations. The resulting Alzheimer's Association Medicare Annual Wellness Visit Algorithm for Assessment of Cognition includes review of patient Health Risk Assessment (HRA) information, patient observation, unstructured queries during the AWV, and use of structured cognitive assessment tools for both patients and informants. Widespread implementation of this algorithm could be the first step in reducing the prevalence of missed or delayed dementia diagnosis, thus allowing for better healthcare management and more favorable outcomes for affected patients and their families and caregivers.

Original languageEnglish (US)
Pages (from-to)141-150
Number of pages10
JournalAlzheimer's and Dementia
Volume9
Issue number2
DOIs
StatePublished - Mar 2013

Keywords

  • AWV
  • Algorithm
  • Alzheimer's disease
  • Annual Wellness Visit
  • Assessment
  • Cognitive impairment
  • Dementia
  • Medicare
  • Patient Protection and Affordable Care Act
  • Screen

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