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

Publication ,  Journal Article
Nowroozpoor, A; Dussetschleger, J; Perry, W; Sano, M; Aloysi, A; Belleville, M; Brackett, A; Hirshon, JM; Hung, W; Moccia, JM; Ohuabunwa, U ...
Published in: Journal of the American Medical Directors Association
August 2022

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).Literature review and consensus-based rankings by a transdisciplinary, stakeholder task force of experts, persons living with dementia, and care partners.Scoping reviews focused on adult ED patients.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.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.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.

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Published In

Journal of the American Medical Directors Association

DOI

EISSN

1538-9375

ISSN

1525-8610

Publication Date

August 2022

Volume

23

Issue

8

Start / End Page

1314.e31 / 1314.e88

Related Subject Headings

  • Sensitivity and Specificity
  • Mass Screening
  • Humans
  • Geriatrics
  • Emergency Service, Hospital
  • Dementia
  • Cognitive Dysfunction
  • Adult
  • 4206 Public health
  • 4205 Nursing
 

Citation

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Chicago
ICMJE
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Nowroozpoor, A., Dussetschleger, J., Perry, W., Sano, M., Aloysi, A., Belleville, M., … GEAR 2.0-ADC Network, . (2022). Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review. Journal of the American Medical Directors Association, 23(8), 1314.e31-1314.e88. https://doi.org/10.1016/j.jamda.2022.03.019
Nowroozpoor, Armin, Jeff Dussetschleger, William Perry, Mary Sano, Amy Aloysi, Michael Belleville, Alexandria Brackett, et al. “Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review.Journal of the American Medical Directors Association 23, no. 8 (August 2022): 1314.e31-1314.e88. https://doi.org/10.1016/j.jamda.2022.03.019.
Nowroozpoor A, Dussetschleger J, Perry W, Sano M, Aloysi A, Belleville M, et al. Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review. Journal of the American Medical Directors Association. 2022 Aug;23(8):1314.e31-1314.e88.
Nowroozpoor, Armin, et al. “Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review.Journal of the American Medical Directors Association, vol. 23, no. 8, Aug. 2022, pp. 1314.e31-1314.e88. Epmc, doi:10.1016/j.jamda.2022.03.019.
Nowroozpoor A, Dussetschleger J, Perry W, Sano M, Aloysi A, Belleville M, Brackett A, Hirshon JM, Hung W, Moccia JM, Ohuabunwa U, Shah MN, Hwang U, GEAR 2.0-ADC Network. Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review. Journal of the American Medical Directors Association. 2022 Aug;23(8):1314.e31-1314.e88.
Journal cover image

Published In

Journal of the American Medical Directors Association

DOI

EISSN

1538-9375

ISSN

1525-8610

Publication Date

August 2022

Volume

23

Issue

8

Start / End Page

1314.e31 / 1314.e88

Related Subject Headings

  • Sensitivity and Specificity
  • Mass Screening
  • Humans
  • Geriatrics
  • Emergency Service, Hospital
  • Dementia
  • Cognitive Dysfunction
  • Adult
  • 4206 Public health
  • 4205 Nursing