Alzheimer’s Association Medicare Annual Wellness Visit February 2013
In December 2012, the Alzheimer’s Association released guidance to help health care providers detect cognitive impairment as part of the Medicare Annual Wellness Visit (AWV). While physicians have been required to include detection of cognitive impairment as part of the AWV since its inception in January 2011, there had not been any comprehensive guidance for physicians on how to undertake the assessment.
In December 2012, the Alzheimer’s Association released guidance to help health care providers detect cognitive impairment as part of the Medicare Annual Wellness Visit (AWV). While physicians have been required to include detection of cognitive impairment as part of the AWV since its inception in January 2011, there had not been any comprehensive guidance for physicians on how to undertake the assessment.
Detecting possible cognitive impairment is critical to the work of public health and the first step in determining whether further evaluation is needed. In developing the recommendations, the Alzheimer’s Association convened an expert workgroup to survey the current literature and build consensus around an effective, practical and easy process that could be used in the primary care setting. The result was the development of an algorithm for the AWV that involves the use of various possible detection tools.
Use of a valid tool allows clinicians to obtain an objective score that can improve detection of cognitive impairment and indicate when a full dementia evaluation is needed. One study found that structured tools detected more than 80 percent of patients who, during follow-up evaluations, were diagnosed with mild cognitive impairment or dementia. That compares to the detection of only 59 percent when initial assessment relied on physician observation alone.
Early diagnosis and detection are part of the Alzheimer’s Association’s public health agenda and are essential to providing the best medical care and outcomes for those with the disease. Even without a way to cure or slow the progression of Alzheimer’s disease, early detection offers the best opportunities for early intervention and maintenance of independent living, including support of healthy living that may lessen secondary disorders and enhance quality of life.
