title: Characteristics of older people with cognitive impairment attending emergency departments: A descriptive study.
abstract: OBJECTIVE
  The objective of this paper is to describe the profile of older people with cognitive impairment (CI) presenting to emergency departments (EDs).
  
  
  METHODS
  This was a multi-centre (n=8) observational study of a convenience sample of older (≥70y) ED patients (n=579). Participants were prospectively assessed for CI and surveyed for the duration of their ED stay (n=191). A picture of patients' health status and ED responses to care needs was obtained through application of standardised assessment tools. Additionally, observations of care processes in ED were undertaken. Demographic data were collected through both ED's information system and survey. Outcome data were collected 28 days post-ED visit using follow-up telephone interviews.
  
  
  RESULTS
  Of 579 older persons, 191 (33%) persons met criteria for CI. The majority of older ED patients with CI in ED lived in the community (157/177, 88.7%), arrived by ambulance (116/172, 67%), were accompanied by a support person (94/149, 63%), were triaged as urgent to semi-urgent (157/191, 82%), and were hospitalised (108/172, 57%). The median ED length of stay was 6h. In ED, 53% of the sample experienced pain (92/173). Older ED patients with CI pose the following characteristics: prior hospital admissions (43/129, 33%), incontinence (61/178, 34%), dependence in activities in daily living (81/190, 43%), issues in nutrition (73/182, 40%), vision and hearing impairment (93% (160/172) and 26% (44/171) respectively).
  
  
  CONCLUSIONS
  Increased understanding of these presenting characteristics and their impacts on patient risk facilitates tailoring the quality of emergency care to better suit the needs and improve outcomes of this increasing ED population.
authors.affiliation: School of Nursing, Queensland University of Technology, Brisbane, Australia; The Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia. Electronic address: linda.schnitker@qut.edu.au.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Schnitker
authors.affiliation: School of Nursing, Queensland University of Technology, Brisbane, Australia.
authors.forename: Elizabeth R A
authors.initials: ER
authors.lastname: Beattie
authors.affiliation: The Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia; Centre for Online Health, The University of Queensland, Brisbane, Australia.
authors.forename: Melinda
authors.initials: M
authors.lastname: Martin-Khan
authors.affiliation: The Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia; Department of Emergency Medicine, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Ellen
authors.initials: E
authors.lastname: Burkett
authors.affiliation: The Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia; Centre for Online Health, The University of Queensland, Brisbane, Australia.
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Gray
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D020958:Australian Capital Territory; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D042241:Early Diagnosis; D016529:Emergency Nursing / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D019338:Polypharmacy; D011446:Prospective Studies; D011793:Queensland; D014739:Victoria
keywords: Aged; Cognitive impairment; Dementia; Emergency nursing; Emergency service; Hospital