Delirium and other cognitive impairment in older adults in an emergency department.
OBJECTIVE
To determine the prevalence of delirium and other alterations in mental status in older adults in the emergency department setting.


METHODS
Prospective, cross-sectional study.


METHODS
Private, nonprofit, academic medical center in a densely populated urban area.


METHODS
One hundred eighty-eight adults 70 years or older who presented to the ED.


METHODS
None.


RESULTS
Delirium and other alterations in mental status were present in 39.9% of the patients studied; 24% of these patients had delirium. Age and severity of illness were positively correlated with alteration in mental status. Patients with alterations in mental status were more likely to be admitted to an inpatient unit. Among those admitted from home, alterations in mental status in the ED were associated with a higher likelihood of institutionalization at discharge.


CONCLUSIONS
Alterations in mental status are prevalent in ED patients. Older adults with alterations in mental status, particularly alterations in consciousness and delirium, are at high risk for admission to an inpatient unit and institutionalization after discharge. Standardized mental status testing identified high-risk older adults in the ED.
Naughton
B J
BJ
Department of Medicine, Northwestern University Medical School, Chicago, Illinois, USA.
Moran
M B
MB
Kadah
H
H
Heman-Ackah
Y
Y
Longano
J
J
D018806:APACHE; D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003693:Delirium / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007326:Institutionalization; D008297:Male; D008609:Mental Status Schedule; D011446:Prospective Studies