Evidence map›Paper›PMID 35790227›Full record

ArticleCMAJ open

Visits to the emergency department by community-dwelling people with dementia during the first 2 waves of the COVID-19 pandemic in Ontario: a repeated cross-sectional analysis.

Laura C Maclagan, Xuesong Wang, Abby Emdin, Aaron Jones, R Liisa Jaakkimainen, Michael J Schull, Nadia Sourial, Isabelle Vedel, Richard H Swartz, Susan E Bronskill

Abstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Differences in admission to trauma centres by sex among adults with traumatic brain injury: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Laura C MaclaganICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Xuesong WangICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Abby EmdinICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Aaron JonesICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
R Liisa JaakkimainenICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Michael J SchullICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Nadia SourialICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Isabelle VedelICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Richard H SwartzICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que.
Susan E BronskillICES Central (Maclagan, Wang, Emdin, Jones, Jaakkimainen, Schull, Swartz, Bronskill); Dalla Lana School of Public Health (Emdin, Schull, Bronskill), Department of Family and Community Medicine (Jaakkimainen) and Division of Neurology (Swartz), Department of Medicine, University of Toronto; Sunnybrook Research Institute (Jaakkimainen, Schull, Bronskill), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Health Research Methods, Evidence, and Impact (Jones, Swartz), McMaster University, Hamilton, Ont.; Department of Health Management, Evaluation and Policy (Sourial), School of Public Health, University of Montreal; Department of Family Medicine (Vedel), McGill University, Montréal, Que. susan.bronskill@ices.on.ca.

Funding

CIHR VR5-172692
6 · The paper itself

Abstract

backgroundCommunity-dwelling people with dementia have been affected by COVID-19 pandemic health risks and control measures that resulted in worsened access to health care and service cancellation. One critical access point in health systems is the emergency department. We aimed to determine the change in weekly rates of visits to the emergency department of community-dwelling people with dementia in Ontario during the first 2 waves of the COVID-19 pandemic compared with historical patterns.

methodsWe conducted a population-based repeated cross-sectional study and used health administrative databases to compare rates of visits to the emergency department among community-dwelling people with dementia who were aged 40 years and older in Ontario during the first 2 waves of the COVID-19 pandemic (March 2020-February 2021) with the rates of a historical period (March 2019-February 2020). Weekly rates of visits to the emergency department were evaluated overall, by urgency and by chapter from the

resultsWe observed large immediate declines in rates of visits to the emergency department during the COVID-19 pandemic (rate ratio [RR] 0.50, 95% confidence interval [CI] 0.47-0.53), which remained below historical levels by the end of the second wave (RR 0.88, 95% CI 0.83-0.92). Rates of both nonurgent (RR 0.33, 95% CI 0.28-0.39) and urgent (RR 0.51, 95% CI 0.48-0.55) visits to the emergency department also declined and remained low (RR 0.68, 95% CI 0.59-0.79, RR 0.91, 95% CI 0.86-0.96), respectively. Visits for injuries, and circulatory, respiratory and musculoskeletal diseases declined and remained below historical levels.

interpretationProlonged reductions in visits to the emergency department among people with dementia during the first 2 pandemic waves raise concerns about patients who delay seeking acute care services. Understanding the long-term effects of these reductions requires further research.

Indexed as

COVID-19DementiaAdultCross-Sectional StudiesEmergency Service, HospitalHumansIndependent LivingMiddle AgedOntarioPandemics

Identifiers

PMID35790227
PMCPMC9262349

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.