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Prevalence of Depression and Cognitive Impairment in Older Adult Emergency Medical Services Patients

Abstract Objectives. To characterize the proportion of older adult emergency department (ED) patients with depression or cognitive impairment. To compare the prevalences of depression or cognitive impairment among ED patients arriving via emergency medical services (EMS) and those arriving via other modes. Methods. Community-dwelling older adults (age ≥60 years) presenting to an academic medical center ED were interviewed. Participants provided demographic and clinical information, and were evaluated for depression and cognitive impairment. Subjects arriving via EMS were compared with those arriving via other modes using the chi-square test, t-test, and the Wilcoxon rank sum test, where appropriate. Results. Consent was obtained from 1,342 eligible older adults; 695 (52%%) arrived via EMS. The median age for those arriving via EMS was 74 years (interquartile range 65, 82), 52%% were female, and 81%% were white. Fifteen percent of EMS patients had moderate or greater depression, as compared with 14%% of patients arriving via other modes (p == 0.52). Thirteen percent of the EMS patients had cognitive impairment, as compared with 8%% of those arriving via other modes (p < 0.01). The depressed EMS patients frequently reported a history of depression (47%%) and taking antidepressants (51%%). The cognitively impaired EMS patients infrequently reported a history of dementia (16%%) and taking medications for dementia (14%%). Conclusions. In this cohort of community-dwelling older adult ED patients, depression and cognitive impairment were common. As compared with ED patients arriving by other transport means, patients arriving via EMS had a similar prevalence of depression but an increased prevalence of cognitive impairment. Screening for depression and cognitive impairment by EMS providers may have value, but needs further investigation.