Case finding for cognitive impairment in elderly emergency department patients

L. W. Gerson, Steven Counsell, P. B. Fontanarosa, W. D. Smucker

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Study objectives: To determine the feasibility of a case-finding program for cognitive impairment in elderly emergency department patients, and to describe the prevalence of cognitive impairment in screened patients and identify factors associated with impairment. Design: A three-month cross- sectional study. The six-item Orientation-Memory-Concentration (OMC) Test was administered to eligible patients. Setting: Community teaching hospital with annual ED census of 69,000 adults. Participants: All patients 65 years of age and older physically able to communicate and without a prior diagnosis of dementia were eligible. Five hundred forty-seven of 958 patients (59%) were interviewed; only 95 (10%) refused. Other reasons for exclusion were too ill, 113 (12%); other (sleeping, privacy, repeat visits, incomplete forms), 99 (10%); known dementia, 59 (6%); and communication problems, 45 (5%). Results: A mean time of 1.9 minutes (±0.91 SD) was required to complete the test. One hundred eighty-three of 547 patients (33.5%) had scores that indicated at least moderate cognitive impairment. Logistic regression analyses identified two factors associated with impairment: age of more than 80 years (odds ratio, 3.68; 95% confidence interval, 2.21-6.14) and residence in a nursing home (odds ratio, 13.8; 95% confidence interval, 3.79-50.2). Conclusion: Screening for cognitive impairment in elderly ED patients using the OMC Test is feasible. There is a high prevalence of cognitive impairment in elderly ED patients, and the prevalence increases with age. Identification of cognitive impairment is important in the assessment of elderly ED patients and may affect clinical evaluation, patients' understanding of medical information, and compliance with discharge instructions.

Original languageEnglish (US)
Pages (from-to)813-817
Number of pages5
JournalAnnals of Emergency Medicine
Volume23
Issue number4
StatePublished - 1994
Externally publishedYes

Fingerprint

Hospital Emergency Service
Dementia
Odds Ratio
Cognitive Dysfunction
Confidence Intervals
Privacy
Community Hospital
Censuses
Nursing Homes
Teaching Hospitals
Cross-Sectional Studies
Logistic Models
Communication
Regression Analysis

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Gerson, L. W., Counsell, S., Fontanarosa, P. B., & Smucker, W. D. (1994). Case finding for cognitive impairment in elderly emergency department patients. Annals of Emergency Medicine, 23(4), 813-817.

Case finding for cognitive impairment in elderly emergency department patients. / Gerson, L. W.; Counsell, Steven; Fontanarosa, P. B.; Smucker, W. D.

In: Annals of Emergency Medicine, Vol. 23, No. 4, 1994, p. 813-817.

Research output: Contribution to journalArticle

Gerson, LW, Counsell, S, Fontanarosa, PB & Smucker, WD 1994, 'Case finding for cognitive impairment in elderly emergency department patients', Annals of Emergency Medicine, vol. 23, no. 4, pp. 813-817.
Gerson, L. W. ; Counsell, Steven ; Fontanarosa, P. B. ; Smucker, W. D. / Case finding for cognitive impairment in elderly emergency department patients. In: Annals of Emergency Medicine. 1994 ; Vol. 23, No. 4. pp. 813-817.
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