Pathway to Detection & Differentiation of Delirium & Dementia in the Emergency Department

This is an observational study of the pragmatic implementation of an ED screening, outpatient referral, and care coordination process for older ED patients who may have UCID.

Completed

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Key information

Conditions

Cognitive Impairment Brain Diseases Central Nervous System Diseases Cognition Disorders Cognitive Dysfunction Confusion Delirium Dementia Emergency Care Mental Disorders Nervous System Diseases Neurobehavioral Manifestations Neurocognitive Disorders Neurologic Manifestations Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

65 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Yale New Haven Hospital, New Haven, Connecticut, United States

About this study

Embedded pragmatic, implementation pilot that incorporates training, ED assessment for delirium and dementia risk, referral of ED patients with undiagnosed cognitive impairment and dementia for primary care feedback and care recommendations. This pilot would gather observational data evaluating the feasibility of incorporating cognitive impairment screens into routine ED delirium assessments, and developing optimal work flow for identifying and referring ED patients with suspected (undiagnosed) dementia for confirmatory evaluation and care coordination.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Adults age 65 or older
Discharged from the adult ED at YNHH or the ED at NMH

Exclusion criteria

Documented or known history of dementia
Alcohol/substance intoxication while in the ED
Non-English or Non-Spanish speaking

Treatment and study plan

PD4ED 3-step intervention (ED assessment, outpatient assessment, Brain health plan)

Diagnostic Test

ED assessment for suspected dementia.
positive ED patients referred for outpatient clinic cognitive impairment assessment.
positive clinic patients referred to primary care with brain health patient plan.

Primary outcomes

Percentage of Patients With Confirmed Delirium or Dementia

Time frame: 1 year

percentage of patients discharged from ED positive for delirium or dementia among total number of patients 65+
Rates of Outpatient Assessment Referral of Patients With Suspected Dementia

Time frame: 30 days

number of patients with appointment to Alzheimer's Dementia Centers or geriatrics outpatient clinic / number of patients given information sheet or referred to outpatient clinic
Number of Participants Diagnosed With Dementia Among Those With Completed Outpatient Assessment

Time frame: Up to 100 days from ED discharge

number of patients diagnosed with dementia (all categories) among those that completed the outpatient assessment
Rates of Connection With Primary Care

Time frame: 30 days

number of patients with PCP follow-up about brain health plan of the number of patients with outpatient confirmation of Dementia or MCI

Sponsors and collaborators

Lead sponsor

Yale University

Other

Collaborators

National Institute on Aging (NIA)

Registry information

Acronym: IMPACT

Important dates

Study start: 2021
Primary completion: 2022
Study completion: 2022
First posted: Apr 15, 2021
Registry last updated: Mar 7, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed