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Management of Older Adults with Dementia in the ER

Int J Geriatr Psychiatry; ePub 2016 Oct 4; Silwanowicz, et al

There are significant differences in the management of dementia with and without neuropsychiatric symptoms (NPS) in an emergency room setting, a recent study found. Researchers conducted a retrospective cohort study that involved the medical and psychiatric emergency departments of a tertiary academic medical center. Participants included patients aged ≥65 years with dementia who presented between February 1, 2012, and July 16, 2014 (n=347). Subjects with documented NPS (n=78) were compared with a group of subjects without documented NPS (n=78) randomly selected from the overall group with dementia. They found:

  • Patients with NPS were more likely to have additional diagnostic testing performed and receive psychotropic medications.
  • Significantly fewer patients with NPS (59.0%) returned to their original setting from the emergency department than patients without NPS (76.9%).
  • Among patients with NPS, those who had a motor disturbance were more likely to receive psychotropic medications than patients who did not have a motor disturbance.
  • Patients with depression/dysphoria or anxiety were more likely to be psychiatrically hospitalized.

Citation:

Silwanowicz RM, Maust DT, Seyfried LS, Chiang C, Stano C, Kales HC. Management of older adults with dementia who present to emergency services with neuropsychiatric symptoms. [Published online ahead of print October 3, 2016]. Int J Geriatr Psychiatry. doi:10.1002/gps.4599.

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