Usage patterns of cognitive assessments during Medicare's Annual Wellness Visit: A national survey

INTRODUCTION

Medicare's Annual Wellness Visit (AWV) is a logical opportunity for early detection of cognitive impairment, but recent data for uptake and cognitive assessments during it are lacking.

METHODS

We surveyed Medicare beneficiaries of a nationally representative panel about use of AWV and cognitive assessments and analyzed associations between uptake and beneficiaries’ characteristics.

RESULTS

Of 1871 participants, 80% had an AWV, among whom 31% underwent formal cognitive testing, 35% were asked about memory problems, including 15% having both. Males, rural residents, non-Hispanic Black beneficiaries, and those having subjective memory problems or a usual source of care were more likely to be probed, but no characteristics were associated with the probability of undergoing cognitive testing.

DISCUSSION

Use of structured cognitive assessments did not increase with higher AWV uptake. Concerningly, individuals at higher risk of cognitive impairment were not more likely to be assessed, calling for policy interventions to increase assessment rates.

Highlights

• Data are lacking on use of cognitive test during Medicare's Annual Wellness Visit (AWV).
• Use of structured cognitive tests did not increase with the uptake of the AWV.
• Individuals at higher risk of cognitive impairment did not receive more testing.
• More high-risk patients were asked about memory problems despite lack of testing.