Glycosylated Hemoglobin Level and Cognitive Decline among Community-Dwelling Older Japanese

This paper describes the profile of older people with cognitive impairment (CI) presenting to Emergency Departments (ED).An observational study of a sample of 579 older (≥ 70 y) ED patients was carried out.Participants were assessed for CI and those screened positive for CI were surveyed duration their ED stay.A picture of patients' health status and ED responses to care needs was obtained through application of standardised geriatric assessment tools.Observations of ED care processes were undertaken and demographic and outcome data were collected through ED's information systems, survey and follow-up telephone interviews.Of 579 older persons, 191 (33%) persons met criteria for CI.The majority of older ED patients with CI in ED lived in the community (157/177, 88.7%), arrived by ambulance (116/172, 67%), were accompanied by a support person (94/149, 63%), were triaged as urgent to semi-urgent (157/191, 82%), and were hospitalised (108/172, 57%).The median ED length of stay was six hours.In ED, 53% of the sample experienced pain (92/173).Older ED patients with CI pose the following characteristics: prior hospital admissions (43/129, 33%), incontinence (61,178, 34%), dependence in activities in daily living (81/190, 43%), issues in nutrition (73/182, 40%), vision and hearing impairment (93% (160/172) and 26% (44/171) respectively).Increased understanding of these characteristics and their impacts on patient risk facilitates tailoring the care to better suit the needs and improve outcomes of this ED population.Best practice and research potentials are discussed.