Page 16 - Layout 1

GERIATRIC
CARE

Alzheimer’s Association

PROVIDES RECOMMENDATIONS FOR
PRIMARY CARE PROVIDERS

By Margaret J. Barron, Executive Director of the Alzheimer’s Association, San Antonio & South Texas Chapter

The Alzheimer’s Association offers guidance to assist health care The Cognitive Assessment Toolkit contains:
providers in detecting cognitive impairment as part of the Medicare
Annual Wellness Visit. As of January 2011, an Annual Wellness Visit • The Medicare Annual Wellness Visit Algorithm for Assessment
is available for all seniors who are Medicare eligible. The benefit was of Cognition, incorporating patient history, clinician observa-
added in the Affordable Care Act, and its purpose is to develop tions, and concerns expressed by the patient, family or caregiver;
strategies with patients to manage their health as well as screen for
select conditions. • Three validated patient assessment tools: the General Practitioner
Assessment of Cognition (GPCOG), the Memory Impairment
Checking for cognitive impairment is part of the visit. Prior to Screen (MIS) and the Mini-Cog. All tools: › Can be administered
Alzheimer’s Association recommendations, there has been no com- in 5 minutes or less › Are equal to or superior to the Mini-Mental
prehensive guidance on how to assess for cognitive impairment in the State Exam (MMSE) for detecting dementia › Are easily admin-
primary care setting. During the visit, the health care provider can use istered by medical staff members who are not physicians › Are rel-
the recommended tools and assess patients’ responses as well as eval- atively free from educational, language and/or cultural bias;
uate family members’ information. These tests along with vital patient
history, self-reported concerns and clinician observations make up the • Three validated informant assessment of patient tools: the Short
first step in determining the need for further evaluation. Form of the Informant Questionnaire on Cognitive Decline in
the Elderly (Short IQCODE), the Eight-item Informant Inter-
As baby boomers turn 65 years old, they advance into an age of view to Differentiate Aging and Dementia (AD8) and the
greater risk for developing Alzheimer’s disease. The Medicare Annual GPCOG;
Wellness Visit could increase timely detection and diagnosis of
Alzheimer’s to allow people affected and their families to better ad- • The “Alzheimer’s Association Recommendations for Operational-
just current lifestyles, engage in learning about care and support, izing the Detection of Cognitive Impairment During the Medical
and plan for the future. Annual Wellness Visit in a Primary Care Setting,” as published
in the journal Alzheimer’s and Dementia.
In developing the recommendations, the Alzheimer’s Association
convened a group of experts to survey the current literature and For general information on the Medicare Annual Wellness Visit,
build consensus around an effective, practical and easy process. In go to alz.org/AWVfacts. More information on the recommenda-
addition to the range of tools identified, the recommendations sug- tions can be found at alz.org/hcps. To receive a free Physicians
gest questions to include in the required Health Risk Assessments Outreach Packet, please call the Alzheimer’s Association San An-
that patients must provide for the visit. tonio and South Texas Chapter office at 210.822.6449.

The recommendations allow physicians to efficiently identify pa-
tients with probable cognitive impairment while allowing flexibility
to choose a cognitive assessment tool that works best for you and
your patients.

The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer’s care, support and research.
Our mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support
for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without
Alzheimer’s. For more information, visit alz.org.

16 San Antonio Medicine • July 2016