Epidemiology of Depression, Anxiety, and Cognitive Impairment
Study Details
Study Description
Brief Summary
Many older adults have undetected health problems and lack basic prevention measures. Failure to identify and treat these conditions can lead to unnecessary morbidity and mortality and a decreased quality of life. Traditional screening and intervention programs, usually based in primary care providers' offices, have been insufficient, particularly in medically underserved populations. Alternate sites for screening and intervention have begun to receive attention and may hold promise.
The emergency department (ED) is the entry point for access to medical and social services for many patients and has the potential to serve as a site to identify older adults with unmet needs. However, we do not know the prevalence of depression and cognitive impairment and how they differ by mode of arrival of the patient to the ED. Second, a question remains as to the validity of screening patients during an acute illness. Upon completion, this study will describe the epidemiology of the population of older adults presenting to the ED.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Detailed Description
Many older adults have undetected health problems and lack basic prevention measures. Failure to identify and treat these conditions can lead to unnecessary morbidity and mortality and a decreased quality of life. Traditional screening and intervention programs, usually based in primary care providers' offices, have been insufficient, particularly in medically underserved populations. Alternate sites for screening and intervention have begun to receive attention and may hold promise.
The emergency department (ED) is the entry point for access to medical and social services for many patients and has the potential to serve as a site to identify older adults with unmet needs. However, we do not know the prevalence of depression and cognitive impairment and how they differ by mode of arrival of the patient to the ED. Second, a question remains as to the validity of screening patients during an acute illness. This study aims to:
-
Compare the prevalence of depression and cognitive impairment among patients who arrive at the ED by EMS, as compared to those arriving via other means.
-
Evaluate the reliability of screening patients for depression and cognitive impairment during an acute illness and after the illness.
-
To evaluate correlates of depression, anxiety and suicidal ideation. Upon completion, this study will describe the epidemiology of the population of older adults presenting to the ED.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Presenting to the ED Patients who present to the ED |
Outcome Measures
Primary Outcome Measures
- Participants With Depression by Patient Health Questionnaire - 9 [2 hours]
Number of participants with depression as measured by the Patient Health Questionnaire - 9, with a score of greater than or equal to 10.
- Participants With Cognitive Impairment by Six Item Screener [2 hours]
Number of participants with cogintiive impairment as measured by the Six Item Screener, with greater than 2 questions incorrect
- Participants With Anxiety by Generalized Anxiety Disorder - 7 [2 hours]
Participants with anxiety as measured by the Generalized Anxiety Disorder - 7, with a score greater than or equal to 10.
Secondary Outcome Measures
- Depression and Cognitive Impairment at 2 Weeks [2 weeks]
For the individuals who are able to be contacted in 2 weeks, how many still test positive for depression and cognitive impairment.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age 60 and older
-
Arrival at ED
Exclusion Criteria:
- Institutionalized
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | University of Rochester | Rochester | New York | United States | 14646 |
Sponsors and Collaborators
- University of Rochester
- National Institute on Aging (NIA)
Investigators
- Principal Investigator: Manish N. Shah, MD MPH, University of Rochester
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- RSRB 24085
- NIH 5K23AG028942
Study Results
Participant Flow
Recruitment Details | |
---|---|
Pre-assignment Detail |
Arm/Group Title | Presenting to the ED |
---|---|
Arm/Group Description | Patients who present to the ED |
Period Title: Overall Study | |
STARTED | 1206 |
COMPLETED | 1206 |
NOT COMPLETED | 0 |
Baseline Characteristics
Arm/Group Title | Presenting to the ED |
---|---|
Arm/Group Description | Patients who present to the ED |
Overall Participants | 1206 |
Age (years) [Median (Inter-Quartile Range) ] | |
Median (Inter-Quartile Range) [years] |
71
|
Sex: Female, Male (Count of Participants) | |
Female |
634
52.6%
|
Male |
572
47.4%
|
Ethnicity (NIH/OMB) (Count of Participants) | |
Hispanic or Latino |
9
0.7%
|
Not Hispanic or Latino |
1184
98.2%
|
Unknown or Not Reported |
13
1.1%
|
Race (NIH/OMB) (Count of Participants) | |
American Indian or Alaska Native |
0
0%
|
Asian |
0
0%
|
Native Hawaiian or Other Pacific Islander |
0
0%
|
Black or African American |
178
14.8%
|
White |
1000
82.9%
|
More than one race |
0
0%
|
Unknown or Not Reported |
28
2.3%
|
Region of Enrollment (participants) [Number] | |
United States |
1206
100%
|
Anxiety (>=10 on GAD7) (participants) [Number] | |
Number [participants] |
119
9.9%
|
Depression (>=10 on PHQ9) (participants) [Number] | |
Number [participants] |
177
14.7%
|
Cognitive Impairment (>2 on SIS) (participants) [Number] | |
Number [participants] |
106
8.8%
|
Outcome Measures
Title | Participants With Depression by Patient Health Questionnaire - 9 |
---|---|
Description | Number of participants with depression as measured by the Patient Health Questionnaire - 9, with a score of greater than or equal to 10. |
Time Frame | 2 hours |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Presenting to the ED |
---|---|
Arm/Group Description | Patients who present to the ED |
Measure Participants | 1206 |
Number [participants] |
177
14.7%
|
Title | Participants With Cognitive Impairment by Six Item Screener |
---|---|
Description | Number of participants with cogintiive impairment as measured by the Six Item Screener, with greater than 2 questions incorrect |
Time Frame | 2 hours |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Presenting to the ED |
---|---|
Arm/Group Description | Patients who present to the ED |
Measure Participants | 1206 |
Number [participants] |
106
8.8%
|
Title | Participants With Anxiety by Generalized Anxiety Disorder - 7 |
---|---|
Description | Participants with anxiety as measured by the Generalized Anxiety Disorder - 7, with a score greater than or equal to 10. |
Time Frame | 2 hours |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Presenting to the ED |
---|---|
Arm/Group Description | Patients who present to the ED |
Measure Participants | 1206 |
Number [participants] |
119
9.9%
|
Title | Depression and Cognitive Impairment at 2 Weeks |
---|---|
Description | For the individuals who are able to be contacted in 2 weeks, how many still test positive for depression and cognitive impairment. |
Time Frame | 2 weeks |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title | Depressed in the ED | Cognitively Impaired in the ED |
---|---|---|
Arm/Group Description | Patients who present to the ED who test positive for depression | Patients presenting to the ED who have cognitive impairment |
Measure Participants | 803 | 808 |
Number (95% Confidence Interval) [participants] |
27
2.2%
|
5
NaN
|
Adverse Events
Time Frame | While enrolled in the study, 2 weeks | |
---|---|---|
Adverse Event Reporting Description | ||
Arm/Group Title | Presenting to the ED | |
Arm/Group Description | Patients who present to the ED | |
All Cause Mortality |
||
Presenting to the ED | ||
Affected / at Risk (%) | # Events | |
Total | / (NaN) | |
Serious Adverse Events |
||
Presenting to the ED | ||
Affected / at Risk (%) | # Events | |
Total | 0/1206 (0%) | |
Other (Not Including Serious) Adverse Events |
||
Presenting to the ED | ||
Affected / at Risk (%) | # Events | |
Total | 0/1206 (0%) |
Limitations/Caveats
More Information
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Name/Title | Manish N. Shah, MD MPH |
---|---|
Organization | University of Rochester |
Phone | 585-275-1198 |
manish.shah@rochester.edu |
- RSRB 24085
- NIH 5K23AG028942