title: Is cognitive function a concern in independent elderly adults discharged home from the emergency department in Canada after a minor injury?
abstract: OBJECTIVE
  To describe the cognitive functioning of independent community-dwelling elderly adults visiting the emergency department (ED) for minor injuries and at 3- and 6-month follow-up assessments and to document the occurrence of falls, return to the ED, and hospital visits over time according to cognitive level.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Three Canadian EDs.
  
  
  METHODS
  Individuals aged 65 and older who were independent in basic activities of daily living, visiting the ED for minor injuries, and discharged home within 48 hours (N = 320).
  
  
  METHODS
  Participants completed the Montreal Cognitive Assessment (MoCA). New falls involving pain and ED or hospital visits were documented at 3 and 6 months.
  
  
  RESULTS
  At baseline, 62.4% of participants scored below the recommended cutoff of 26 on the MoCA, suggesting cognitive dysfunction, and 22.9% scored below a more-stringent cutoff of 21. MoCA scores had improved significantly at 3 and 6 months. Items showing the most improvement were delayed recall and verbal fluency. Persons with MoCA scores of less than 21 reported significantly more new falls and hospital visits 3 to 6 months after injury.
  
  
  CONCLUSIONS
  Cognition is not optimal in many community-dwelling elderly adults visiting an ED for a minor injury, which may affect their capacity to comprehend, recall, and adhere to medical recommendations after their injury and put them at risk of further negative health events such as falls.
authors.affiliation: Unité de recherche en traumatologie- urgence- soins intensifs, Axe de Recherche en Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du Centre Hospitalier Universitaire de Québec, Québec, Québec, Canada; Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec, Québec, Canada; School of Psychology, Université Laval, Québec, Québec, Canada.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Ouellet
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Sirois
authors.forename: Simon
authors.initials: S
authors.lastname: Beaulieu-Bonneau
authors.forename: Jacques
authors.initials: J
authors.lastname: Morin
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Perry
authors.forename: Raoul
authors.initials: R
authors.lastname: Daoust
authors.forename: Laura
authors.initials: L
authors.lastname: Wilding
authors.forename: Véronique
authors.initials: V
authors.lastname: Provencher
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Camden
authors.forename: Nadine
authors.initials: N
authors.lastname: Allain-Boulé
authors.forename: Marcel
authors.initials: M
authors.lastname: Émond
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004282:Documentation / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D057187:Independent Living; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011792:Quebec; D012016:Reference Values; D012307:Risk Factors; D012648:Self Care; D013223:Statistics as Topic; D014600:Utilization Review / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000628:therapy*
keywords: Montreal Cognitive Assessment; cognitive status; emergency medicine; geriatrics; minor injury