SynthesisAge and ageing2021
Screening instruments for cognitive impairment in older patients in the Emergency Department: a systematic review and meta-analysis.
Synthesis in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma in acute care settings: a systematic review.European geriatric medicine · 2026Pooled it
- Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Pooled it
- Multidimensional Preinjury Health and 6-month Outcome After Traumatic Brain Injury in Older Adults Presenting With Mainly GCS 13-15.The Journal of head trauma rehabilitation · 2026Article
- Early Diagnosis of Delirium in Geriatric Patients in Emergency Departments: A Systematic Review and Meta-Analysis.Brain sciences · 2026Review
- Targeted Delirium Screening in At-risk Older Adults in the Emergency Department Improves Screening Rates.Journal of the American College of Emergency Physicians open · 2026Article
- The limited diagnostic and prognostic utility of brief cognitive screening tools in acute stroke.European stroke journal · 2026Article
- Two Brief Steps, Better Foresight: Cognitive Screening and Adverse Outcomes in Older Adults Admitted From the Emergency Department.Journal of the American Geriatrics Society · 2026Article
- Identifying frailty in acutely hospitalised patients with hip fracture: are the clinical frailty scale and irish hip fracture database frailty index comparable for predicting adverse outcomes?European geriatric medicine · 2026Article
- 4AT screening for delirium in dementia: meta-analysis of diagnostic performance.Dementia & neuropsychologia · 2026Review
- NOTICE-ED: Nurse or Technician Insights Into Cognitive Evaluations in the Emergency Department.Journal of the American Geriatrics Society · 2025Article
- Article
- Detection and differentiation of undiagnosed dementia in the emergency department: A pilot referral pathway.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- The 4AT scale for rapid detection of delirium in emergency department triage.Frontiers in medicine · 2024Article
- Diagnostic accuracy of the Dutch version of the 4AT for delirium detection in a mixed patient population and setting.Aging clinical and experimental research · 2023Observational
- A survey on the availability of geriatric-friendly protocols, equipment and physical environment across emergency departments in Flanders, Belgium.BMC geriatrics · 2023Article
- Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review.Journal of the American Medical Directors Association · 2022Article
- Impaired Executive Function and Depression as Independent Risk Factors for Reported Delirium Symptoms: An Observational Cohort Study Over 8 Years.Frontiers in aging neuroscience · 2021Article
- "Emergency Room Evaluation and Recommendations" (ER2) Tool for the Screening of Older Emergency Department Visitors With Major Neurocognitive Disorders: Results From the ERFrontiers in neurology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundcognitive impairment is highly prevalent among older patients attending the Emergency Department (ED) and is associated with adverse outcomes.
methodswe conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of cognitive screening instruments to rule out cognitive impairment in older patients in the ED. A comprehensive literature search was performed in MEDLINE, EMBASE, CINAHL and CENTRAL. A risk of bias assessment using QUADAS-2 was performed.
results23 articles, examining 18 different index tests were included. Only seven index tests could be included in the meta-analysis. For ruling out cognitive impairment irrespective of aetiology, Ottawa 3 Day Year (O3DY) (pooled sensitivity 0.90; (95% CI) 0.71-0.97) had the highest sensitivity. Fourteen articles focused on screening for cognitive impairment specifically caused by delirium. For ruling out delirium, the 4 A's Test (4AT) showed highest sensitivity (pooled sensitivity 0.87, 95% confidence interval (95% CI) 0.74-0.94).
conclusionshigh clinical and methodological heterogeneity was found between included studies. Therefore, it is a challenge to recommend one diagnostic test for use as a screening instrument for cognitive impairment in the ED. The 4AT and O3DY seem most promising for ruling out cognitive impairment in older patients attending the ED.The review protocol was registered in PROSPERO (CRD42018082509).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.