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Correlates of cognitive functioning in independent elderly patients discharged home from the emergency department after a minor injury

Published online by Cambridge University Press:  25 April 2016

Marie-Christine Ouellet*
Affiliation:
Centre de recherche du CHU de Québec, Québec, QC, Canada Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, QC, Canada École de psychologie, Université Laval, Québec, QC, Canada
Marie-Josée Sirois
Affiliation:
Centre de recherche du CHU de Québec, Québec, QC, Canada Département de réadaptation, Université Laval, Québec, QC, Canada
Simon Beaulieu-Bonneau
Affiliation:
Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, QC, Canada École de psychologie, Université Laval, Québec, QC, Canada
Marie-Ève Gagné
Affiliation:
Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, QC, Canada École de psychologie, Université Laval, Québec, QC, Canada
Jacques Morin
Affiliation:
Centre de recherche du CHU de Québec, Québec, QC, Canada
Jeffrey Perry
Affiliation:
The Ottawa Hospital, Ottawa, ON, Canada Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
Raoul Daoust
Affiliation:
Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada Département de médecine de famille et médecine d'urgence, Université de Montréal, Montréal, QC, Canada
Laura Wilding
Affiliation:
The Ottawa Hospital, Ottawa, ON, Canada
Véronique Provencher
Affiliation:
Département de réadaptation, Université Laval, Québec, QC, Canada
Stéphanie Camden
Affiliation:
Centre de recherche du CHU de Québec, Québec, QC, Canada
Nadine Allain-Boulé
Affiliation:
Centre de recherche du CHU de Québec, Québec, QC, Canada
Marcel Émond
Affiliation:
Centre de recherche du CHU de Québec, Québec, QC, Canada Département de Médecine Familiale et de Médecine d'urgence, Université Laval, Québec, QC, Canada
*
Correspondence should be addressed to: Marie-Christine Ouellet PhD, Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Institut de réadaptation en déficience physique de Québec, 525 boulevard Hamel, Québec, QC, G1M 2S8, Canada. Phone: +418-529-9141, Fax: +418-529-3548. Email: marie-christine.ouellet@psy.ulaval.ca.

Abstract

Background:

The objective of this study was to explore correlates of cognitive functioning of older adults visiting the emergency department (ED) after a minor injury.

Methods:

These results are derived from a large prospective study in three Canadian EDs. Participants were aged ≥ 65 years and independent in basic activities of daily living, visiting the ED for minor injuries and discharged home within 48 hours (those with known dementia, confusion, and delirium were excluded). They completed the Montreal Cognitive Assessment (MoCA). Potential correlates included sociodemographic and injury variables, and measures of psychological and physical health, social support, mobility, falls, and functional status.

Results:

Multivariate analyses revealed that male sex, age ≥ 85 years, higher depression scores, slower walking speed, and self-reported memory problems were significantly associated with lower baseline MoCA scores.

Conclusions:

These characteristics could help ED professionals identify patients who might need additional cognitive evaluations or follow-ups after their passage through the ED. Obtaining information on these characteristics is potentially feasible in the ED context and could help professionals alter favorably elderly's trajectory of care. Since a significant proportion of elderly patients consulting at an ED have cognitive impairment, the ED is an opportunity to prevent functional and cognitive decline.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2016 

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