THE ROLES OF HEALTH SERVICES ON THE ASSOCIATION BETWEEN MEDICARE ANNUAL WELLNESS VISITS AND EARLY DEMENTIA DIAGNOSES

Sep 29, 2026

Early recognition of cognitive impairment (CI) depends on timely diagnosis of mild CI (MCI) and Alzheimer’s Disease and Related Dementia (ADRD). Data were lacking on how guideline-informed health services are delivered after Medicare Annual Wellness Visits (AWVs) in pathways leading to MCI/ADRD diagnoses. Using a Texas Medicare propensity cohort (n=66,433 per group) with one-year follow-up from the first AWV or index date in 2018, AWV receipt corresponded to a 41% MCI diagnosis increase and an 8% ADRD diagnosis increase, largely explained by post-AWV specialist referrals, lab tests, and brain imaging.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Study background and objective

Guideline-informed services assessed

Cohort design and follow-up

Outcomes: MCI and ADRD diagnosis associations

Interpretation and implications

844 Innovation in Aging, 2025, Vol. 9, No. S2 Mukaila Raji1, Huey-Ming Tzeng2, Yong Shan3, Jeong Jang4, Peter Cram5, and Yong-Fang Kuo6, 1. University of Texas Medical Branch at Galveston, Galveston, Texas, United States, 2. School of Nursing, University of Texas Medical Branch, Galveston, Galveston, Texas, United States, 3. UTMB, Galvesto, Texas, United States, 4. UTMB Health, The University of Texas Medical Branch, Galveston, Texas, United States, 5. University of Maryland, Baltimore County, Baltimore, Maryland, United States, 6. University of Texas Medical Branch, Galveston, Galveston, Texas, United States Early recognition of cognitive impairment (CI) and timely diagnoses of mild CI (MCI) and Alzheimer’s Disease and Related Dementia (ADRD) are key to optimal dementia care. Currently there are no data describing the rates of guideline-informed health services (specific blood tests – vitamin B12, thyroid stimulating hormone; specialist referrals – neurology, psychiatry; and brain images – CT, MRI) conducted after Medicare Annual Wellness Visits (AWVs) in evaluation processes leading to MCI/ ADRD diagnosis. Using propensity study cohort of Texas fee-forservice Medicare enrollees,(n = 66,433 at each group), we followed health services utilization and MCI/ADRD diagnosis within one-year of the first AWV or the index date for thenon-AWV group in 2018. Both groups had similar proportion of patients who received specific blood tests, specialist referrals, and brain images in the 12 months before AWV/index date. Among those with no previous specialist visits, 4.1% in theAWV group and 3.5% in the non-AWV group got specialist referralsin the follow-up period. Among those with no previous brain images, 12.4% in AWV group and 11.7% in non-AWV group got brain images in the follow-up period. AWV receipt was associated with 41% increase in MCI diagnosis—with about 20% of the increase accounted for by post-AWV specialist referrals, lab tests, and brain images. AWV receipt was also associated with an 8% increase in ADRD diagnosis—with about 75% of the increase accounted for by the three guideline-informed health services. This study suggests that receipt of Medicare AWV has larger direct effect on the identification of early CI. Abstract citation ID: igaf122.2860 THE ROLES OF HEALTH SERVICES ON THE ASSOCIATION BETWEEN MEDICARE ANNUAL WELLNESS VISITS AND EARLY DEMENTIA DIAGNOSES

FAQs

What was the study’s main goal regarding Medicare AWVs and dementia outcomes?

To quantify whether guideline-informed health services conducted after Medicare Annual Wellness Visits are associated with subsequent diagnosis of MCI and ADRD within one year.

Which guideline-informed health services were evaluated after the AWV or index date?

Specific blood tests (vitamin B12, thyroid stimulating hormone), specialist referrals (neurology, psychiatry), and brain imaging (CT, MRI).

How did receiving an AWV relate to MCI and ADRD diagnosis rates?

AWV receipt was associated with a 41% increase in MCI diagnosis and an 8% increase in ADRD diagnosis, with substantial portions of those increases explained by post-AWV specialist referrals, lab tests, and brain images.

Sep 29, 2026

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