A “significant portion” of community-dwelling older adults with dementia display a pattern of repeated emergency department (ED) visits, according to a new study published in the Journal of the American Geriatrics Society.
The study analyzed ED visits among community-dwelling adults aged 66 years and older living in Ontario, Canada, over nearly 10 years. Among more than 175,000 participants, the groups at highest risk of recurrent ED visits included patients who were more frequently prescribed anticonvulsants, antipsychotics and benzodiazepines, and those who resided in rural and low-income areas.
The study also found that a history of an ED visit or visits during the prior year was the strongest predictor of recurrent visits and perhaps the most useful for identifying older adults in need of interventions.
Dementia prevalence is expected to increase globally, from 57 million in 2020 to 153 million by 2050, but higher healthcare costs and barriers to diagnosis and care access are creating health disparities, lead researcher Aaron Jones, PhD, of McMaster University in Canada, and colleagues wrote.
“In our study, the risk associated with even a single visit in the previous year was higher than the next strongest risk factor of being 95 years or older,” they reported. “Past ED use would be a useful measure to identify patients who would benefit from closer follow-up, geriatric referral, ED-to-community transition support, and closer engagement with primary care and home care.”
To further improve these patients’ care experiences, shared decision-making, collaborative medication review, and closer follow-up and engagement with community supports may be necessary, the researchers added.
The authors also advocate for dementia-friendly and geriatric-focused EDs.
