Epidemiology of Depression, Anxiety, and Cognitive Impairment

Epidemiology of Depression, Anxiety, and Cognitive Impairment Among Emergency Department Patients

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.

Study Overview

• Status: Completed
• Conditions: Depression; Cognitive Impairment; Anxiety

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:

1. 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.
2. Evaluate the reliability of screening patients for depression and cognitive impairment during an acute illness and after the illness.
3. 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 Type: Observational
• Enrollment (Actual): 1206

Contacts and Locations

Study Locations

• United States
  • New York
    • Rochester, New York, United States, 14646
      • University of Rochester

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All older adults arriving at participating hospital emergency departments to obtain emergency care.

Description

Inclusion Criteria:

• Age 60 and older
• Arrival at ED

Exclusion Criteria:

• Institutionalized

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Presenting to the ED; Patients who present to the ED

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Participants With Depression by Patient Health Questionnaire - 9	Number of participants with depression as measured by the Patient Health Questionnaire - 9, with a score of greater than or equal to 10.	2 hours
Participants With Cognitive Impairment by Six Item Screener	Number of participants with cogintiive impairment as measured by the Six Item Screener, with greater than 2 questions incorrect	2 hours
Participants With Anxiety by Generalized Anxiety Disorder - 7	Participants with anxiety as measured by the Generalized Anxiety Disorder - 7, with a score greater than or equal to 10.	2 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depression and Cognitive Impairment at 2 Weeks	For the individuals who are able to be contacted in 2 weeks, how many still test positive for depression and cognitive impairment.	2 weeks

Collaborators and Investigators

• Sponsor: University of Rochester
• Collaborators: National Institute on Aging (NIA)
• Investigators: Principal Investigator: Manish N. Shah, MD MPH, University of Rochester

Study record dates

Study Major Dates

• Study Start: May 1, 2008
• Primary Completion (Actual): September 1, 2008
• Study Completion (Actual): February 1, 2009

Study Registration Dates

• First Submitted: July 14, 2008
• First Submitted That Met QC Criteria: July 14, 2008
• First Posted (Estimate): July 16, 2008

Study Record Updates

• Last Update Posted (Estimate): June 15, 2015
• Last Update Submitted That Met QC Criteria: June 12, 2015
• Last Verified: June 1, 2015

More Information

Terms related to this study

• Keywords: Depression; Anxiety; Cognitive Impairment; Emergency medicine; prehospital care
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Mood Disorders; Neurocognitive Disorders; Cognition Disorders; Depression; Depressive Disorder; Anxiety Disorders; Cognitive Dysfunction
• Other Study ID Numbers: RSRB 24085; NIH 5K23AG028942