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.
Bibliographical noteFunding Information:
Over the past 5 years, Malaz Boustani has received research support for investigator- initiated projects from Forest Pharmaceutical and Novartis ; honoraria from Norvartis and Pfizer, Inc. ; and research support for investigator-initiated projects from the NIH and AHRQ . Dr Boustani was a member of the US Preventive Services Task Force that published the systematic evidence review, Dementia Screening, for the AHRQ in 2003.
- Alzheimer's disease
- Annual Wellness Visit
- Cognitive impairment
- Patient Protection and Affordable Care Act