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Multicenter study of case finding in elderly emergency department patients
L W Gerson1, E W Rousseau, T M Hogan
1Division of Community Health Sciences, Northeastern Ohio Universities College of Medicine, Akron, USA.
Summary
A brief screening program effectively identified numerous functional, cognitive, and social impairments in elderly emergency department patients, proving its feasibility and highlighting significant unmet health needs in this population.
Area of Science:
- Geriatric Medicine
- Emergency Medicine
- Public Health
Background:
- Elderly patients frequently present to emergency departments (EDs) with undiagnosed functional, cognitive, and social impairments.
- Early detection of these issues is crucial for improving health outcomes and reducing healthcare utilization.
Purpose of the Study:
- To evaluate the feasibility of a brief, comprehensive case-finding program for elderly ED patients.
- To determine the prevalence of previously unknown, undetected, or untreated impairments in this demographic.
Main Methods:
- A multicenter prospective study involving patients aged 60+ discharged from EDs.
- A standardized 17-item protocol administered by trained medical students.
- Physician follow-up questionnaires to confirm diagnoses and treatment plans.
Main Results:
- 75% of eligible elderly patients participated; 96% had conditions detected.
- Common issues included activities of daily living limitations (79%), vision problems (55%), and depression (36%).
- Physician follow-up confirmed new problems in 62% of cases, with treatment plans initiated for 53%.
Conclusions:
- A brief, comprehensive screening program is feasible for identifying impairments in elderly ED patients.
- The screening revealed substantial, often undiagnosed, morbidity in this vulnerable population.