Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review

Journal of the American Medical Directors Association

Nowroozpoor, A., Dussetschleger, J., et al. (2022).

Journal of the American Medical Directors Association, 23(8), 1314-1314.

<div>This scoping review investigates the psychometric properties and other characteristics (e.g., feasibility, acceptability) of assessments for identifying cognitive impairment, cognitive frailty, or confusion in adult emerency department (ED) patients at risk for dementia.</div>

National Institute on Aging, National Institutes of Health

From database inception to March 25, 2024

<div>Published studies (Not further specified)</div>

90 total articles

<div>Three assessment tools demonstrated high sensitivty, negative predictive value, and short administration times for identifying cognitive impairment in adult ED patients at risk for dementia. Specific findings include the following:</div> <ul> <li><strong>Six-item Screener (SIS):</strong> sensitivity ranging from 63 to 94%, specificity ranging from 77 to 86%, negative predicitve value of 98%, and administration time of less than 1 minute;</li> <li><strong>Ottawa 3DY (O3DY)-English:</strong> sensitivity ranging from 71.4 to 95%, specificity ranging from 50 to 72.8%, and administration time of less than 2 minutes; and</li> <li><strong>4 A's Test (4AT):</strong> sensitivity ranging from 49 to 84%, specificity ranging from 74 to 87%, negative predicitve value ranging from 88 to 98%, and administration time of less than 3 minutes.</li> </ul> <div>Limitations of this review include the paucity of research and the heterogeneity of findings. Additional research is needed to develop accurate, feasible, and culturally and linguistically responsive tools for identifying cognitive impairment and differentiating delirium and dementia in adult ED patients.</div>