Epidemiology of Depression, Anxiety, and Cognitive Impairment

Study Overview
=================
Brief Summary
-----------------
Many older adults have undetected health problems and lack basic prevention measures. Failure to identify and treat these conditions can lead to unnecessary morbidity and mortality and a decreased quality of life. Traditional screening and intervention programs, usually based in primary care providers' offices, have been insufficient, particularly in medically underserved populations. Alternate sites for screening and intervention have begun to receive attention and may hold promise. The emergency department (ED) is the entry point for access to medical and social services for many patients and has the potential to serve as a site to identify older adults with unmet needs. However, we do not know the prevalence of depression and cognitive impairment and how they differ by mode of arrival of the patient to the ED. Second, a question remains as to the validity of screening patients during an acute illness. Upon completion, this study will describe the epidemiology of the population of older adults presenting to the ED.

Detailed Description
-----------------
Many older adults have undetected health problems and lack basic prevention measures. Failure to identify and treat these conditions can lead to unnecessary morbidity and mortality and a decreased quality of life. Traditional screening and intervention programs, usually based in primary care providers' offices, have been insufficient, particularly in medically underserved populations. Alternate sites for screening and intervention have begun to receive attention and may hold promise. The emergency department (ED) is the entry point for access to medical and social services for many patients and has the potential to serve as a site to identify older adults with unmet needs. However, we do not know the prevalence of depression and cognitive impairment and how they differ by mode of arrival of the patient to the ED. Second, a question remains as to the validity of screening patients during an acute illness. This study aims to: Compare the prevalence of depression and cognitive impairment among patients who arrive at the ED by EMS, as compared to those arriving via other means. Evaluate the reliability of screening patients for depression and cognitive impairment during an acute illness and after the illness. To evaluate correlates of depression, anxiety and suicidal ideation. Upon completion, this study will describe the epidemiology of the population of older adults presenting to the ED.

Official Title
-----------------
Epidemiology of Depression, Anxiety, and Cognitive Impairment Among Emergency Department Patients

Conditions
-----------------
Depression, Anxiety, Cognitive Impairment

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age 60 and older Arrival at ED Exclusion Criteria: Institutionalized

Ages Eligible for Study
-----------------
Minimum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Presenting to the ED<br>Patients who present to the ED | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Participants With Depression by Patient Health Questionnaire - 9 | Number of participants with depression as measured by the Patient Health Questionnaire - 9, with a score of greater than or equal to 10. | 2 hours | 
| Participants With Cognitive Impairment by Six Item Screener | Number of participants with cogintiive impairment as measured by the Six Item Screener, with greater than 2 questions incorrect | 2 hours | 
| Participants With Anxiety by Generalized Anxiety Disorder - 7 | Participants with anxiety as measured by the Generalized Anxiety Disorder - 7, with a score greater than or equal to 10. | 2 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression and Cognitive Impairment at 2 Weeks | For the individuals who are able to be contacted in 2 weeks, how many still test positive for depression and cognitive impairment. | 2 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Depression, Anxiety, Cognitive Impairment, Emergency medicine, prehospital care