Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review

Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment

“…ED discharge care transitions have been prioritized within the 2014 Geriatric ED Guidelines 1 and the 2018 launch of the American College of Emergency Physicians geriatric ED accreditation process. 14 Recent ED-centric initiatives, as part of the Geriatric Emergency care Applied Research 2.0 Network -Advancing Dementia Care, [15][16][17][18] identified the need for the development of patient-and care partner-reported outcome measures that capture what matters most to stakeholders during ED care transitions. 6,9 As a first step toward developing a novel care partner-reported outcome measure, we sought to assess the barriers experienced by care partners of PLWCI during ED discharge care transitions.…”

Aren't you forgetting something? Cognitive screening beyond delirium in the emergency department

“…Nonetheless, cognitive assessments at the ED are scarce and primarily focused on delirium 3,4 . Although delirium is a central aspect of acute geriatric care, patients with pre‐existing cognitive impairment without delirium are at high risk of going undetected 5 . Up to 63% of older adults hospitalized due to acute illnesses have some cognitive impairment 6 .…”

“…Up to 63% of older adults hospitalized due to acute illnesses have some cognitive impairment 6 . Thus, identifying cognitive impairment in the ED became a priority, particularly in the absence of delirium or previous dementia diagnosis 5 …”

“…Given the insufficient research on the assessment and prognostic implications of delirium and cognitive impairment comorbidity, 5 we aimed to describe their prevalence and prognostic implications for adverse in‐hospital outcomes in acutely ill older patients admitted from the ED.…”

The Geriatric-Focused Emergency Department: Opportunities and Challenges

“…Of all aspects of geriatric emergency department care, perhaps the most need is for system change related to care of persons with Alzheimer's disease and related dementias (ADRD), and the research to guide that change. 28,29 Fortunately, with support from the US National Institute on Aging, a recent series of studies has focused on this issue, resulting in separate reviews on detecting cognitive impairment and dementia in emergency department settings, 30 communication with persons with ADRD and their families, 31 optimal emergency department services for persons with ADRD, 32 and management of care transitions in persons with ADRD. 33 As in virtually all aspects of medicine, progress in improving the care of older persons is incremental and painfully slow.…”