Depression and Cognitive Impairment in Older Adult Emergency Department Patients: Changes over 2 Weeks

作者：Shah Manish N^*; Richardson Thomas M; Jones Courtney M C; Swanson Peter A; Schneider Sandra M; Katz Paul; Conwell Yeates

来源：Journal of the American Geriatrics Society, 2011, 59(2): 321-326.

DOI：10.1111/j.1532-5415.2010.03268.x

• emergency care
• depression
• cognitive impairment
• geriatrics
• prevention

OBJECTIVES
To evaluate older adult emergency department (ED) patients for depression and cognitive impairment and to re-evaluate those findings 2 weeks later.
DESIGN
Prospective cohort study.
SETTING
ED.
PARTICIPANTS
One thousand two hundred six older community-dwelling ED patients consented to participate; 811 (67%) completed the 2-week follow-up.
MEASUREMENTS
Screening for depression (9-item Patient Health Questionnaire) and cognitive impairment (Six-Item Screener) was performed. Changes were evaluated through paired comparisons.
RESULTS
At 2-week follow-up, for depression, 27 of 97 (28%) with baseline positive tests remained positive, and 22 of 706 (3%) with baseline negative tests were positive. At 2-week follow-up, for cognitive impairment, five of 43 (12%) with baseline positive tests remained positive, and 11 of 765 (1%) with baseline negative tests were positive.
CONCLUSION
Significant variability exists for depression and cognitive impairment testing completed during and after the ED visit, with markedly fewer subjects testing positive at follow-up. The variability may reflect changes in clinical state, confounding from other conditions, or poor validity of the instruments in the ED setting. Further studies are needed to explain these findings before case-finding for these conditions is implemented in the ED setting.

• 出版日期2011-2