Annual Wellness Visits Linked With Higher Rates of New Dementia Medication Prescriptions

Medicare beneficiaries with Alzheimer disease and related dementias (ADRD) who received more annual wellness visits (AWVs) had higher rates of new dementia medication prescriptions, according to a retrospective cohort study published in JAMA Network Open.

CMS began reimbursing AWVs in 2011 for beneficiaries 65 years and older, and the visits must include a cognitive assessment. Investigators noted that it remained unclear whether AWVs lead to new prescriptions of memantine or the acetylcholinesterase inhibitors (AChEIs) donepezil, rivastigmine, and galantamine.

Using 100% Medicare data, the researchers identified 799,268 beneficiaries with ADRD who were newly diagnosed in 2018 or had prevalent ADRD diagnosed from 2015 through 2017, all with continuous Medicare Parts A, B, and D enrollment and no prior dementia medication prescriptions. Overall, 60.8% had received no AWVs in the 3 years before the index date, 19.2% received 1, 12.9% received 2, and 7.2% received 3 or more. New dementia medication prescriptions in the following year ranged from 9.8% among those with no AWVs to 14.1% among those with 3 or more. After propensity score weighting, receipt of 3 or more AWVs was associated with a 16% higher prescription rate than no AWVs and receipt of 1 or 2 AWVs was associated with 9% and 12% higher rates, respectively.

The association differed between beneficiaries with incident and prevalent dementia, with larger increases among those newly diagnosed. Among prevalent cases, receipt of 3 or more AWVs was associated with a 6% higher rate. No interaction was observed by dementia severity, sex, race, urbanicity, or educational level, and findings were consistent in sensitivity analyses of memantine and AChEIs separately.

The authors noted that causality cannot be determined and that patient self-selection for AWVs may not be captured in administrative data. The cohort excluded managed care enrollees and was restricted to Part D enrollees, which the authors said may inflate the association relative to the broader Medicare population. Claims reflected prescription fills rather than use, and the data could not show whether a full dementia evaluation was performed. The investigators concluded that AWVs may have an important role in increasing prescribing of medications that help manage ADRD symptoms.

Source: Milani SA, Kuo YF, Shan Y, et al. Annual wellness visits and new dementia medication prescriptions among US Medicare beneficiaries. JAMA Netw Open. 2026;9(10):e2640804. doi:10.1001/jamanetworkopen.2026.40804