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.
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.
Authors: Christopher R Carpenter; Elizabeth R Bassett; Grant M Fischer; Jonathan Shirshekan; James E Galvin; John C Morris Journal: Acad Emerg Med Date: 2011-04 Impact factor: 3.451
Authors: Christopher R Carpenter; Kennon Heard; Scott Wilber; Adit A Ginde; Kirk Stiffler; Lowell W Gerson; Neal S Wenger; Douglas K Miller Journal: Acad Emerg Med Date: 2011-06 Impact factor: 3.451
Authors: David Barbic; Brian Kim; Qadeem Salehmohamed; Kate Kemplin; Christopher R Carpenter; Skye Pamela Barbic Journal: BMJ Open Date: 2018-03-16 Impact factor: 2.692
Authors: William Perry; Laura Lacritz; Tresa Roebuck-Spencer; Cheryl Silver; Robert L Denney; John Meyers; Charles E McConnel; Neil Pliskin; Deb Adler; Christopher Alban; Mark Bondi; Michelle Braun; Xavier Cagigas; Morgan Daven; Lisa Drozdick; Norman L Foster; Ula Hwang; Laurie Ivey; Grant Iverson; Joel Kramer; Melinda Lantz; Lisa Latts; Shari M Ling; Ana Maria Lopez; Michael Malone; Lori Martin-Plank; Katie Maslow; Don Melady; Melissa Messer; Randi Most; Margaret P Norris; David Shafer; Nina Silverberg; Colin M Thomas; Laura Thornhill; Jean Tsai; Nirav Vakharia; Martin Waters; Tamara Golden Journal: Arch Clin Neuropsychol Date: 2018-09-01 Impact factor: 2.813