Journal article
A systematic review of interventions for persons living with dementia: The Geriatric ED Guidelines 2.0
Academic emergency medicine, Vol.33(1), e70074
01/2026
DOI: 10.1111/acem.70074
PMCID: PMC12834197
PMID: 40534401
Appears in UI Libraries Support Open Access
Abstract
The increasing prevalence of dementia poses significant challenges for emergency department (ED) care, as persons living with dementia (PLWD) more frequently experience adverse outcomes such as delirium, prolonged stays, and higher mortality rates. Despite advancements in care strategies, a critical gap remains in understanding how ED interventions impact outcomes in this vulnerable population. This systematic review aims to identify evidence-based ED care interventions tailored to PLWD to improve outcomes.
A systematic review was conducted in Ovid MEDLINE, Cochrane Library (Wiley), Scopus (Elsevier), and ProQuest Dissertations & Theses Global through September 2024. The review protocol was registered on PROSPERO (CRD42024586555). Eligible studies included randomized controlled trials, observational studies, and quality improvement initiatives focused on ED interventions for PLWD. Data extraction and quality assessment were performed independently by two reviewers, with disagreements resolved through discussion. Outcomes included patient satisfaction, ED revisits, functional decline, and mortality.
From 3305 screened studies, six met the inclusion criteria. Interventions included nonpharmacologic therapies (e.g., music and light therapy), specialized geriatric ED units, and assessment tools, such as for pain. Tailored interventions including geriatric emergency units and community paramedic care transitions were effective in reducing 30-day ED revisits and hospitalizations. However, heterogeneity in study designs and outcomes precluded meta-analysis. Risk of bias ranged from low to moderate.
This review underscores the urgent need for standardized and evidence-based interventions in ED settings for PLWD. Approaches including multidisciplinary care models and nonpharmacologic therapies demonstrated potential for improving outcomes. Future research should prioritize consistent outcome measures, interdisciplinary collaboration, and person-centered care strategies to enhance the quality and equity of ED services for PLWD.
Details
- Title: Subtitle
- A systematic review of interventions for persons living with dementia: The Geriatric ED Guidelines 2.0
- Creators
- Sangil Lee - University of IowaMichelle Suh - University of ChicagoLuna Ragsdale - Durham VA Health Care SystemJustine Seidenfeld - Durham VA Health Care SystemJames D van Oppen - University of SheffieldLauren Lapointe-Shaw - University of TorontoCarolina Diniz Hooper - Yale UniversityJames Jaramillo - Quinnipiac UniversityAnnie B Wescott - Northwestern UniversityAlexander X Lo - Northwestern UniversityKaiho Hirata - International University of Health and WelfareMaura Kennedy - Massachusetts General HospitalLauren Cameron Comasco - Oakland UniversityChristopher R Carpenter - Mayo ClinicTeresita M Hogan - University of ChicagoShan W Liu - Massachusetts General HospitalGeriatric ED Guidelines Dementia Writing Group
- Resource Type
- Journal article
- Publication Details
- Academic emergency medicine, Vol.33(1), e70074
- DOI
- 10.1111/acem.70074
- PMID
- 40534401
- PMCID
- PMC12834197
- NLM abbreviation
- Acad Emerg Med
- ISSN
- 1553-2712
- eISSN
- 1553-2712
- Publisher
- Wiley
- Grant note
- John A. Hartford Foundation West health
- Language
- English
- Electronic publication date
- 06/19/2025
- Date published
- 01/2026
- Academic Unit
- Emergency Medicine; Injury Prevention Research Center
- Record Identifier
- 9984832187802771
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