Logo image
Back
A Systematic Review of Interventions for Persons Living With Dementia: The Geriatric ED Guidelines 2.0
Preprint   Open access

A Systematic Review of Interventions for Persons Living With Dementia: The Geriatric ED Guidelines 2.0

Sangil Lee, Michelle Suh, Luna Ragsdale, Justine Seidenfeld, James D. van Oppen, Lauren Lapointe-Shaw, Carolina Diniz Hooper, James Jaramillo, Annie B. Wescott, Kaiho Hirata, …
medRxiv
Cold Spring Harbor Laboratory Press, 1.1
03/03/2025
DOI: 10.1101/2025.02.28.25323113
PMCID: PMC11908280
PMID: 40093231
url
https://doi.org/10.1101/2025.02.28.25323113View
Preprint (Author's original)This preprint has not been evaluated by subject experts through peer review. Preprints may undergo extensive changes and/or become peer-reviewed journal articles. 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 3,305 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 non-pharmacologic 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. Tailored interventions such as geriatric ED units and community paramedic care transitions significantly reduce ED revisits and hospital admissions among persons living with dementia. Non-pharmacologic therapies, including music and light interventions, show potential for improving patient outcomes, though results are heterogeneous and require further validation. The review highlights the urgent need for standardized protocols and interdisciplinary approaches to enhance emergency care for this vulnerable population. This paper addresses critical knowledge gaps concerning emergency care for persons living with dementia, offering evidence-based insights to improve outcomes and guide the development of standardized, person-centered interventions in ED settings.
 Emergency Medicine

Details

Metrics

6 Record Views
Logo image