TOPLINE

Patients who had an annual wellness visit were more likely to be diagnosed with mild cognitive impairment within a year, partly because of an increase in follow‑up lab tests.

METHODOLOGY

• Researchers conducted a retrospective cohort study to assess whether Medicare annual wellness visits were linked to improved diagnoses of cognitive issues and dementia.
• They analyzed Medicare claims data from Texas (2015 to 2019), identifying beneficiaries aged 68 years or older with enrollment in Parts A and B.
• After propensity score matching, two cohorts of 66,443 beneficiaries each (58% women) were formed: One had an annual wellness visit, and the other had a primary care visit alone.
• The outcome was the first diagnosis of mild cognitive impairment or Alzheimer’s disease and related dementias within a year of follow-up.
• Researchers recorded post-visit use of lab tests based on guidelines, neurology/psychiatry referrals, and brain imaging.

TAKEAWAY

• Among beneficiaries with no prior lab tests, those who had annual wellness visits underwent lab tests more often than those who had primary care visit alone during follow‑up (39.2% vs 31.1%; P < .0001).
• Beneficiaries who had annual visits had a 29% higher risk of being diagnosed with mild cognitive impairment than those who had primary care visit (adjusted hazard ratio, 1.29; 95% CI, 1.15-1.45).
• Lab tests accounted for approximately 14% of the increased risk for the diagnosis of mild cognitive impairment after annual visits.
• Undergoing an annual wellness visit was not associated with an increased risk for the diagnosis of Alzheimer’s disease and related dementias.

IN PRACTICE

“[The] study suggests that receipt of an annual wellness visit has a larger direct effect on the identification of early cognitive impairment, with a smaller (indirect) effect of lab tests on the identification of early cognitive impairment,” the researchers wrote.

SOURCE

The study was led by Yong-Fang Kuo of University of Texas Medical Branch in Galveston. It was published online on July 24 in the Journal of the American Geriatrics Society.

LIMITATIONS

Specialist referrals counted only outpatient visits to certain specialists and missed consults. New biomarkers of Alzheimer’s disease were not examined.

DISCLOSURES

The study received support from the National Institute on Aging of the National Institutes of Health. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.