and related dementia will cost our nation $345 billion, not including the value of unpaid caregiving. By 2050, it is estimated that these direct costs will increase to nearly $1 trillion. 3. Cognitive impairment detection benefit in the medicare annual wellness visit and initial preventive physical examination (a) Annual wellness visit (1) In general Section 1861(hhh)(2) of the Social Security Act ( 42 U.S.C. 1395x(hhh)(2) ) is amended by striking subparagraph (D) and inserting the following: (D) Detection of any cognitive impairment that shall— (i) be performed using one of the cognitive impairment detection tools identified by the National Institute on Aging as meeting its criteria for selecting instruments to detect cognitive impairment in the primary care setting