Older adults in the emergency department: A systematic review of patterns of use, adverse outcomes, and effectiveness of interventions

2002 ◽  
Vol 39 (3) ◽  
pp. 238-247 ◽  
Author(s):  
Faranak Aminzadeh ◽  
William Burd Dalziel
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Emergency Department ◽  
Adverse Outcomes ◽  
Patterns Of Use

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

scholarly journals Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gijs Hesselink ◽  
Özcan Sir ◽  
Yvonne Schoon
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Emergency Department ◽  
Older Patients ◽  
Elderly Care ◽  
Rapid Assessment ◽  
Experimental Studies ◽  
Design Quality ◽  
Content Type ◽  
Ed Crowding

Abstract Background The growing demand for elderly care often exceeds the ability of emergency department (ED) services to provide quality of care within reasonable time. The purpose of this systematic review is to assess the effectiveness of interventions on reducing ED crowding by older patients, and to identify core characteristics shared by successful interventions. Methods Six major biomedical databases were searched for (quasi)experimental studies published between January 1990 and March 2017 and assessing the effect of interventions for older patients on ED crowding related outcomes. Two independent reviewers screened and selected studies, assessed risk of bias and extracted data into a standardized form. Data were synthesized around the study setting, design, quality, intervention content, type of outcome and observed effects. Results Of the 16 included studies, eight (50%) were randomized controlled trials (RCTs), two (13%) were non-RCTs and six (34%) were controlled before-after (CBA) studies. Thirteen studies (81%) evaluated effects on ED revisits and four studies (25%) evaluated effects on ED throughput time. Thirteen studies (81%) described multicomponent interventions. The rapid assessment and streaming of care for older adults based on time-efficiency goals by dedicated staff in a specific ED unit lead to a statistically significant decrease of ED length of stay (LOS). An ED-based consultant geriatrician showed significant time reduction between patient admission and geriatric review compared to an in-reaching geriatrician. Conclusion Inter-study heterogeneity and poor methodological quality hinder drawing firm conclusions on the intervention’s effectiveness in reducing ED crowding by older adults. More evidence-based research is needed using uniform and valid effect measures. Trial registration The protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017075575).

scholarly journals Frailty Predicts Some but Not All Adverse Outcomes in Older Adults Discharged from the Emergency Department

2008 ◽  
Vol 56 (9) ◽  
pp. 1651-1657 ◽  
Author(s):  
S. Nicole Hastings ◽  
Jama L. Purser ◽  
Kimberly S. Johnson ◽  
Richard J. Sloane ◽  
Heather E. Whitson
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Adverse Outcomes

Advance Directives for Older Adults in the Emergency Department: A Systematic Review

2015 ◽  
Vol 18 (6) ◽  
pp. 500-505 ◽  
Author(s):  
Jeremy Oulton ◽  
Suzanne Michelle Rhodes ◽  
Carol Howe ◽  
Mindy J. Fain ◽  
Martha Jane Mohler
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Emergency Department ◽  
Advance Directives
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