ArticleHealth services research2021
The effect of direct cognitive assessment in the Medicare annual wellness visit on dementia diagnosis rates.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Pooled it
- Understanding barriers to and facilitators of clinician-patient conversations about brain health and cognitive concerns in primary care: a systematic review and practical considerations for the clinician.BMC primary care · 2023Pooled it
- Documented follow-up to memory concerns reported at the Medicare Annual Wellness Visit.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Delaying Screening Until Covered? Changes in Lung Cancer Screening at the Age of Nearly-Universal Medicare Insurance.Health services research · 2026Article
- Navigating Alzheimer's Disease in Primary Care: Practical Strategies for Diagnosis and Management.International journal of general medicine · 2026Review
- A Qualitative Study of a Pilot of Clinician Perspectives on the Delivery of Medicare Annual Wellness Visits for Patients with Dementia in an Academic Health Science Center in Texas.Health services insights · 2026Article
- End-of-Life Care for Older Adults With Dementia by Race and Ethnicity and Physicians' Role.JAMA health forum · 2025Article
- An innovative health systems approach to support early detection of cognitive impairment in primary care - the brain health navigator.BMC primary care · 2025Article
- What Helps or Hinders Annual Wellness Visits for Detection and Management of Cognitive Impairment Among Older Adults? A Scoping Review Guided by the Consolidated Framework for Implementation Research.Nursing reports (Pavia, Italy) · 2025Review
- "It's Usually Not Dementia That's the Focus": Barriers and Facilitators of Dementia Care in Primary Care.Journal of general internal medicine · 2025Article
- Family physicians' perspectives on outcomes, processes, and policies in dementia care.Health affairs scholar · 2025Article
- Developing a prediction model for cognitive impairment in older adults following critical illness.BMC geriatrics · 2024Article
- The Medicare annual wellness visit: An opportunity to improve health system identification of hearing loss?Journal of the American Geriatrics Society · 2024Article
- Annual Wellness Visits and Early Dementia Diagnosis Among Medicare Beneficiaries.JAMA network open · 2024Article
- Analysis of agreement between measures of subjective cognitive impairment and probable dementia in the National Health and Aging Trends Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- The Annual Wellness Visit Health Risk Assessment: Potential of Patient Portal-Based Completion and Patient-Oriented Education and Support.Innovation in aging · 2024Article
- The intersection of social determinants of health and family care of people living with Alzheimer's disease and related dementias: A public health opportunity.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Adoption and Value of the Medicare Annual Wellness Visit: A Mixed-Methods Study.Medical care research and review : MCRR · 2023Article
- Impact of diagnosed (vs undiagnosed) dementia on family caregiving experiences.Journal of the American Geriatrics Society · 2023Article
- Care for Hearing Loss and Best Principles of Dementia Care: The Time is Right for Inclusion.Journal of the American Medical Directors Association · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the relationship between direct cognitive assessment introduced with the Medicare Annual Wellness Visit (AWV) and new diagnoses of dementia, and to determine if effects vary by race. DATA SOURCES: Medicare Limited Data Set 5% sample claims 2003-2014 and the HRSA Area Health Resources Files. STUDY
designInstrumental Variable approach estimating the relationship between AWV utilization and new diagnoses of dementia using county-level Welcome to Medicare Visit rates as an instrument. DATA COLLECTION/EXTRACTION
methodsThree hundred twenty-four thousand three hundred and eighty-five fee-for-service Medicare beneficiaries without dementia when the AWV was introduced in 2011. PRINCIPAL
findingsAnnual Wellness Visit utilization was associated with an increased probability of new dementia diagnosis with effects varying by racial group (categorized as white, black, Hispanic/Latino, or Asian based on Social Security Administration data). Hazard ratios (95% confidence intervals) for new dementia diagnosis within 6 months of AWV utilization were as follows: 2.34 (2.13, 2.58) white, 2.22 (1.71, 2.89) black, 4.82 (2.94, 7.89) Asian, and 6.14 (3.70, 10.19) Hispanic (P < .001 for each). Our findings show that estimates that do not control for selection underestimate the effect of AWV on new diagnoses.
conclusionsDementia diagnosis rates increased with AWV implementation with heterogenous effects by race and ethnicity. Current recommendations by the United States Preventive Services Task Force state that the evidence is insufficient to recommend for or against screening for cognitive impairment in older adults.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.