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

Aminzadeh, Faranak; Dalziel, William Burd

doi:10.1067/mem.2002.121523

Cited by 1,119Emergency and Acute Care StudiesHospital Admissions and OutcomesFrailty in Older Adults

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

Aminzadeh, Faranak, Dalziel, William Burd·2002·Annals of Emergency Medicine

DOI 10.1067/mem.2002.121523

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Abstract

Study objective We sought to synthesize the literature on patterns of use of emergency services among older adults, risk factors associated with adverse health outcomes, and effectiveness of intervention strategies targeting this population.Methods Relevant articles were identified by means of an English-language search of MEDLINE, HealthSTAR, CINAHL, Current Contents, and Cochrane Library databases from January 1985 to January 2001. This search was supplemented with literature from reference sections of the retrieved publications. A qualitative approach was used to synthesize the literature.Results Compared with younger persons, older adults use emergency services at a higher rate, their visits have a greater level of urgency, they have longer stays in the emergency department, they are more likely to be admitted or to have repeat ED visits, and they experience higher rates of adverse health outcomes after discharge. The risk factors commonly associated with the negative outcomes are age, functional impairment, recent hospitalization or ED use, living alone, and lack of social support. Comprehensive geriatric screening and coordinated discharge planning initiatives designed to improve clinical outcomes in older emergency patients have provided inconclusive results.Conclusion Older ED patients have distinct patterns of service use and care needs. The current disease-oriented and episodic models of emergency care do not adequately respond to the complex care needs of frail older patients. More research is needed to determine the effectiveness of screening and intervention strategies targeting at-risk older ED patients.

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In older adults attending emergency departments, social isolation and living alone were found to be associated with hospital admission in a systematic review of 14 studies.
“In older adults attending emergency departments, social isolation and living alone were found to be associated with hospital admission in a systematic review of 14 studies 26 .”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as [26]
The overview found an association (+) between social isolation and general health and wellbeing, supported by one review or multiple lower quality reviews.
“| General health & wellbeing (Aminzadeh & Dalziel 2002, Annear et al 2014, Chen et al 2014, Pinquart & Sorensen 2000) | + | + | |”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as Aminzadeh & Dalziel 2002
The overview found an association (+) between loneliness and general health and wellbeing, supported by one review or multiple lower quality reviews.
“| General health & wellbeing (Aminzadeh & Dalziel 2002, Annear et al 2014, Chen et al 2014, Pinquart & Sorensen 2000) | + | + | |”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as Aminzadeh & Dalziel 2002

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Authors: Aminzadeh, F., & Dalziel, W. B.
Venue: Annals of Emergency Medicine
Publisher: Elsevier BV
Published: 2002-03
Volume: 39
Issue: 3
Pages: 238-247
ISSN: 0196-0644 (ISSN-L)
DOI: 10.1067/mem.2002.121523
OpenAlex: W2166332563
Cited by: 1,119
References: 85
Citations by year: 2026: 38 · 2025: 38 · 2024: 65 · 2023: 73 · 2022: 70 · 2021: 82 · 2020: 82 · 2019: 62 · 2018: 58 · 2017: 67 · 2016: 66 · 2015: 62 · 2014: 66 · 2013: 51 · 2012: 53
FWCI: 3.18
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Annals of Emergency Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords: older adults, emergency department utilization, emergency department visits, adverse health effects, functional disability, social support, living alone, geriatric screening, discharge planning, emergency department length of stay, hospitalization, frailty, risk factors
MeSH terms: Aged, Emergency Service, Hospital, Female, Health Services Needs and Demand, Humans, Length of Stay, Male, Risk Factors, Geriatric Assessment, Treatment Outcome

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

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