TY - JOUR
T1 - Detecting Cognitive Impairment and Dementia in the Emergency Department
T2 - A Scoping Review
AU - GEAR 2.0 ADC Network
AU - Nowroozpoor, Armin
AU - Dussetschleger, Jeff
AU - Perry, William
AU - Sano, Mary
AU - Aloysi, Amy
AU - Belleville, Michael
AU - Brackett, Alexandria
AU - Hirshon, Jon Mark
AU - Hung, William
AU - Moccia, Joan Michelle
AU - Ohuabunwa, Ugochi
AU - Shah, Manish N.
AU - Hwang, Ula
AU - Aggarwal, Neelum
AU - Fernanda Bellolio, M.
AU - Betz, Marian (Emmy)
AU - Biese, Kevin
AU - Brandt, Cynthia
AU - Bruursema, Stacey
AU - Carnahan, Ryan
AU - Carpenter, Christopher R.
AU - Carr, David
AU - Chin-Hansen, Jennie
AU - Daven, Morgan
AU - Degesys, Nida
AU - Dresden, Scott M.
AU - Ellenbogen, Michael
AU - Falvey, Jason
AU - Foster, Beverly
AU - Gettel, Cameron
AU - Gilmore-Bykovskyi, Andrea
AU - Goldberg, Elizabeth
AU - Han, Jin
AU - Hardy, James
AU - Nicole Hastings, S.
AU - Hogan, Teresita
AU - Isaacs, Eric
AU - Jaspal, Naveena
AU - Johnson, Jerry
AU - Kelly, Kathleen
AU - Kennedy, Maura
AU - Kind, Amy
AU - Malone, Michael
AU - Moreno, Monica
AU - Morrow-Howell, Nancy
AU - Oiyemhonlan, Brenda
AU - Resendez, Jason
AU - Rising, Kristin L.
AU - Savage, Bob
AU - Suyama, Joe
N1 - Publisher Copyright:
© 2022
PY - 2022/8
Y1 - 2022/8
N2 - Objectives: To identify research and practice gaps to establish future research priorities to advance the detection of cognitive impairment and dementia in the emergency department (ED). Design: Literature review and consensus-based rankings by a transdisciplinary, stakeholder task force of experts, persons living with dementia, and care partners. Setting and Participants: Scoping reviews focused on adult ED patients. Methods: Two systematic scoping reviews of 7 medical research databases focusing on best tools and approaches for detecting cognitive impairment and dementia in the ED in terms of (1) most accurate and (2) most pragmatic to implement. The results were screened, reviewed, and abstracted for relevant information and presented at the stakeholder consensus conference for discussion and ranked prioritization. Results: We identified a total of 1464 publications and included 45 to review for accurate tools and approaches for detecting cognitive impairment and dementia. Twenty-seven different assessments and instruments have been studied in the ED setting to evaluate cognitive impairment and dementia, with many focusing on sensitivity and specificity of instruments to screen for cognitive impairment. For pragmatic tools, we identified a total of 2166 publications and included 66 in the review. Most extensively studied tools included the Ottawa 3DY and Six-Item Screener (SIS). The SIS was the shortest to administer (1 minute). Instruments with the highest negative predictive value were the SIS (vs MMSE) and the 4 A's Test (vs expert diagnosis). The GEAR 2.0 Advancing Dementia Care Consensus conference ranked research priorities that included the need for more approaches to recognize more effectively and efficiently persons who may be at risk for cognitive impairment and dementia, while balancing the importance of equitable screening, purpose, and consequences of differentiating various forms of cognitive impairment. Conclusions and Implications: The scoping review and consensus process identified gaps in clinical care that should be prioritized for research efforts to detect cognitive impairment and dementia in the ED setting. These gaps will be addressed as future GEAR 2.0 research funding priorities.
AB - Objectives: To identify research and practice gaps to establish future research priorities to advance the detection of cognitive impairment and dementia in the emergency department (ED). Design: Literature review and consensus-based rankings by a transdisciplinary, stakeholder task force of experts, persons living with dementia, and care partners. Setting and Participants: Scoping reviews focused on adult ED patients. Methods: Two systematic scoping reviews of 7 medical research databases focusing on best tools and approaches for detecting cognitive impairment and dementia in the ED in terms of (1) most accurate and (2) most pragmatic to implement. The results were screened, reviewed, and abstracted for relevant information and presented at the stakeholder consensus conference for discussion and ranked prioritization. Results: We identified a total of 1464 publications and included 45 to review for accurate tools and approaches for detecting cognitive impairment and dementia. Twenty-seven different assessments and instruments have been studied in the ED setting to evaluate cognitive impairment and dementia, with many focusing on sensitivity and specificity of instruments to screen for cognitive impairment. For pragmatic tools, we identified a total of 2166 publications and included 66 in the review. Most extensively studied tools included the Ottawa 3DY and Six-Item Screener (SIS). The SIS was the shortest to administer (1 minute). Instruments with the highest negative predictive value were the SIS (vs MMSE) and the 4 A's Test (vs expert diagnosis). The GEAR 2.0 Advancing Dementia Care Consensus conference ranked research priorities that included the need for more approaches to recognize more effectively and efficiently persons who may be at risk for cognitive impairment and dementia, while balancing the importance of equitable screening, purpose, and consequences of differentiating various forms of cognitive impairment. Conclusions and Implications: The scoping review and consensus process identified gaps in clinical care that should be prioritized for research efforts to detect cognitive impairment and dementia in the ED setting. These gaps will be addressed as future GEAR 2.0 research funding priorities.
KW - Dementia
KW - cognitive impairment
KW - emergency department
UR - http://www.scopus.com/inward/record.url?scp=85135548066&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2022.03.019
DO - 10.1016/j.jamda.2022.03.019
M3 - Article
C2 - 35940682
AN - SCOPUS:85135548066
SN - 1525-8610
VL - 23
SP - 1314-1315.e55
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 8
ER -