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Cognitive Impairment in the ED

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Geriatric Emergencies

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Abstract

Efforts to support cognitive function in the emergency department (ED) setting should be performed given the significant volume of patients with dementia and delirium and opportunities for intervention in the ED. Older adults prioritize retention of their memory and independence; therefore, detection of new or progressive cognitive impairment in the ED can facilitated patient- and caregiver-centered care. Delirium detection can be performed with the Confusion Assessment Method, a well-validated tool with widespread use by clinicians and non-clinicians. Aging-friendly EDs should adopt both delirium preventive and treatment measures into their care of older adults. Multiple dementia assessments are available, with the Short Blessed Test being both sensitive and time efficient. Opportunities for specialized inpatient programs, such as Acute Care for Elders, and early outpatient referrals should be considered for patients diagnosed with new or progressive dementia in the ED.

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Abbreviations

ACE:

Acute care for elders

AD8:

Alzheimer’s disease-8

ADL:

Activity of daily living

AGS:

American Geriatrics Society

BAS:

Brief Alzheimer Screen

bCAM:

Brief Confusion Assessment Method

CAM:

Confusion assessment method

DLB:

Dementia with Lewy bodies

DSM-5 :

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

ED:

Emergency department

EQUiPPED:

Enhancing quality of prescribing practices for older veterans discharged from the emergency department

FTD:

Frontotemporal dementia

GNL:

Geriatric nurse liaison

GRACE:

Geriatric Resources for Assessment and Care of Elders

HBPC:

Home-based primary care

HELp:

Hospital Elder Life Program

MMSE:

Mini-mental state examination

MoCA:

Montreal cognitive assessment

O3DY:

Ottawa 3 day-year

OMCT:

Orientation-memory-concentration test

PIM:

Potentially inappropriate medication

QCS:

Quick confusion scale

SAEM:

Society of Academic Emergency Medicine

SBT:

Short blessed test

SIS:

Six-item screener

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Authors and Affiliations

  1. Medicine Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA

    Jill M. Huded & Todd I. Smith

  2. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Jill M. Huded & Todd I. Smith

Authors
  1. Jill M. Huded
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  2. Todd I. Smith
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Corresponding author

Correspondence to Jill M. Huded .

Editor information

Editors and Affiliations

  1. Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Lee A. Lindquist

  2. Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Scott M. Dresden

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Huded, J.M., Smith, T.I. (2019). Cognitive Impairment in the ED. In: Lindquist, L., Dresden, S. (eds) Geriatric Emergencies. Springer, Cham. https://doi.org/10.1007/978-3-030-12414-4_3

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  • DOI: https://doi.org/10.1007/978-3-030-12414-4_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12413-7

  • Online ISBN: 978-3-030-12414-4

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