Annual Wellness Visits and New Dementia Medication Prescriptions Among US Medicare Beneficiaries

Importance: Medicare annual wellness visits (AWVs) may facilitate early diagnosis of Alzheimer disease and related dementias (ADRDs). However, it remains unclear whether AWVs lead to increased new prescriptions of dementia medications, including N-methyl-d-aspartate receptor antagonists (memantine) and acetylcholinesterase inhibitors (donepezil, rivastigmine, and galantamine). Objective: To examine the association between incident AWVs and new dementia medication prescriptions. Design, Setting, and Participants: This retrospective cohort study used 100% Medicare data for beneficiaries with ADRDs diagnosed from January 1 to December 31, 2018, who had continuous enrollment in Medicare Parts A, B, and D, from 3 years before to 1 year after the index date (January 1, 2018), excluding those enrolled in health maintenance organizations and with prior dementia medication prescriptions. Data analysis was performed from August 2025 to August 2026. Exposure: Number of AWVs received in the 3 years before the index date (0, 1, 2, or ≥3). Main Outcomes and Measures: Receipt of any dementia medication (yes or no). Results: In this cohort of 799 268 Medicare beneficiaries with ADRDs (mean [SD] age, 82.3 [7.9] years; 64.5% female), 60.8% received no AWVs, 19.2% received 1 AWV, 12.9% received 2 AWVs, and 7.2% received 3 or more AWVs. New dementia medication prescriptions ranged from 9.8% to 14.1%, varying by number of AWVs received. After propensity score weighting, receipt of 1 AWV was associated with a 9.0% higher rate in dementia medication prescriptions (hazard ratio [HR], 1.09; 95% CI, 1.07-1.11), receipt of 2 AWVs was associated with a 12.0% higher rate (HR, 1.12; 95% CI, 1.10-1.14), and receipt of 3 or more AWVs was associated with a 16.0% higher rate (HR, 1.16; 95% CI, 1.13-1.19). An interaction between AWVs and prevalent cases of dementia was observed (P for interaction = .009). For both incident and prevalent cases of dementia, a higher rate of dementia medications was associated with a higher number of AWVs, but those with incident dementia cases had larger increases. Conclusions and Relevance: In this cohort study of Medicare beneficiaries with ADRD, an increasing number of AWVs received was associated with higher rates of new dementia medication prescriptions. These findings underscore the important role that AWVs may have in increasing the prescribing of medications that help manage symptoms of ADRD and suggest AWVs are essential to support quality dementia care (eg, symptom management) and advance care planning for future living arrangements.