Index Visit/Initial Signs

Index visit

An index visit is any visit in which the patient or family member of the patient identifies a specific memory issue of the patient, the health care provider recognizes signs of cognitive impairment, or an annual wellness visit triggers concern. The tools and resources in this section help establish a baseline assessment of changes in behavior or memory and function of your patients.

Resources

Suggested: The most effective, comprehensive, and evidence-based information.
Additional: Other approaches physicians and other caregivers may find useful.


Suggested Physician Resources

Assessing Cognitive Impairment in Older Adults(www.nia.nih.gov) Provided by the Alzheimer’s Disease Education and Referral Center, this resource is a quick guide for physicians to help assess and screen for cognitive impairment in your patients.

Annual Wellness Visit (AWV)(www.cms.gov)
The Annual Wellness Visit (AWV) is a Medicare benefit added through the Patient Protection and Affordable Care Act. The AWV focuses on long-term preventive care. Detection of cognitive impairment is a component of the AWV. This resource provides information on the AWV benefit, eligibility, required components, and coding and billing specifics. AAFP members can access our easy-to-read supplement on AWVs here.

Family Questionnaire(www.alz.org)
The Family Questionnaire is a five-question survey to ask family and friends to help determine evidence of cognitive impairment in a patient. The surveys are evaluated by the health provider, who then advises on any need for additional testing.


Additional Physician Resources

Special Issues in Memory Loss, Alzheimer’s Disease and Dementia(www.alz.org)
The Alzheimer’s Association provides two case studies as examples of how to address cognitive impairment. They focus on addressing sensitive issues regarding cognitive impairment with the patient and family.