Annual wellness visits may be critical to identify mild cognitive impairment (MCI) early among Medicare beneficiaries, which could drive more proactive care, a new study finds.
The report was published Tuesday in JAMA Network Open.
Researchers specifically looked at the link between annual wellness visits (AWVs) and an MCI or a dementia diagnosis. To do so, the team evaluated enrollment and claims data from 549,516 community-dwelling Medicare beneficiaries, ages 68 and older, with no diagnosis of MCI, or Alzheimer’s disease and related dementias (ADRD) before 2018.
The team primarily used patient visits from 2018 as the index date, and looked at the link between visits and diagnoses over a five-year span.
Annual wellness visits were associated with a 21% increase in MCI diagnosis and a 4% increase in diagnosis of Alzheimer’s or a related dementia compared with those who didn’t have a wellness visit. “In other words,” the authors said, “AWV recipients had a higher rate of first MCI diagnosis, with little difference in first ADRD diagnosis.”
Those who had an annual wellness visit had a 5.2% probability of developing MCI or ADRD by the one-year follow-up, a 9.8% probability at the two-year follow-up and 22.8% likelihood five years later. Those who didn’t have a wellness visit had a 4.5% probability of diagnosis after one year, 8.9% at the two-year follow-up and 21.3% at the five-year follow-up.
The probability of developing Alzheimer’s or a related dementia in those who had a wellness visit was 4.1% one year after the visit, 7.9% at the two-year follow-up and 18.6% at the five-year follow-up. Among those who didn’t have a wellness visit, the probability for dementia was 3.8% at the one-year follow-up, 7.5% two years later and 17.7% at the five-year follow-up.
The study also found that those who had wellness visits received a diagnosis of MCI about 76 days earlier than those who did not go for a checkup.
“These findings underscore the importance of annual wellness visits in facilitating early diagnosis and timely management of cognitive impairment in older adults,” wrote the authors of a commentary that was published in the same journal.
“This study suggests that Medicare annual wellness visits may increase early MCI recognition, leading to more proactive care in such older adults,” the authors wrote in the study.
