Reasons for repeated emergency department visits among community‐dwelling older adults with dementia in Ontario, Canada
Abstract
Background: Community‐dwelling older adults living with dementia visit the emergency department (ED) more frequently than other older adults, but research on the reasons for repeated visits is lacking. We examined the rate of repeated ED visits and reasons for visits in a cohort of individuals with dementia. Methods: We conducted a population‐based retrospective cohort study of community‐dwelling older adults (≥66 years) living with dementia in Ontario, Canada, who visited the ED and were discharged home between April 1, 2010, and March 31, 2019. We calculated the proportion of the population with one, two, and three or more repeat ED visits within 1 year of the baseline visit and the categorized the reason for the visits. Results: Our cohort contained 175,863 individuals with dementia who visited the ED at least once. Overall, 66.1% returned at least once to the ED within 1 year, 39.4% returned twice, and 23.5% returned 3 or more times. Visit reasons were heterogenous and were most frequently related to general signs and symptoms (25.3%) while being infrequently due to cognitive or behavioral reasons (5.9%). Individuals typically visited for different reasons across successive visits. Conclusions: Community‐dwelling older adults with dementia who visited an ED were very likely to return to the ED within a year, with a substantial proportion visiting multiple times. The high frequency of repeated visits for different reasons highlights the complexity of caring for this population and indicates greater need for comprehensive community and primary care as well as timely communication between the ED and the community.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Community-dwelling older adults living with dementia are at high risk for repeated emergency department visits.
“Community-dwelling older adults living with dementia are at high risk for repeated emergency department (ED) visits.[13][14][15]”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [13]
The authors' previous study found that serial emergency department visits in people with dementia tended to be for different reasons.
“Our previous study on recurrent ED visits in people with dementia found that serial visits tended to be for different reasons, suggesting that the repeat visits are not likely due to a single health problem.13”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [13]
Repeat emergency department visits in people with dementia are not likely due to a single health problem.
“Our previous study on recurrent ED visits in people with dementia found that serial visits tended to be for different reasons, suggesting that the repeat visits are not likely due to a single health problem.13”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [13]
There is heterogeneity in visit reasons across serial emergency department visits.
“Given our previous research demonstrating heterogeneity in visit reasons across serial ED visits, 13”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [13]
There are groups of older adults who regularly utilize the emergency department as a standard part of their care.
“the strong association between past ED visits and recurrent visits suggests that there are groups of older adults who regularly utilize the ED as a standard part of their care.”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [13]
Cites
Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S., Huang, H., Zhang, L., Zhou, X., Du, C., et al. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.0994 · Cited by 8,249 · see citing works
Canadian Institute for Health Information.
Lalonde, A. (1994) · PubMed · Cited by 4,730 · see citing works
Aminzadeh, F., & Dalziel, W. B. (2002) · Annals of Emergency Medicine · doi:10.1067/mem.2002.121523 · Cited by 1,119 · see citing works
Comorbidity and dementia: a scoping review of the literature
Bunn, F., Burn, A.-M., Goodman, C., Rait, G., Norton, S., Robinson, L., Schoeman, J., & Brayne, C. (2014) · BMC Medicine · doi:10.1186/s12916-014-0192-4 · Cited by 451 · see citing works
Delirium in Older Emergency Department Patients: Recognition, Risk Factors, and Psychomotor Subtypes
Han, J. H., Zimmerman, E. E., Cutler, N. S., Schnelle, J. F., Morandi, A., Dittus, R. S., Storrow, A. B., & Ely, E. W. (2009) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2008.00339.x · Cited by 435 · see citing works
Jaakkimainen, R. L., Bronskill, S. E., Tierney, M. C., Herrmann, N., Green, D., Young, J., Ivers, N., Butt, D., Widdifield, J., & Tu, K. (2016) · Journal of Alzheimer's Disease · doi:10.3233/jad-160105 · Cited by 305 · see citing works
Self-citationReducing Frequent Visits to the Emergency Department: A Systematic Review of Interventions
Soril, L. J. J., Leggett, L. E., Lorenzetti, D. L., Noseworthy, T. W., & Clement, F. M. (2015) · PLOS ONE · doi:10.1371/journal.pone.0123660 · Cited by 251 · see citing works
Understanding and improving multidisciplinary team working in geriatric medicine
Ellis, G., & Sevdalis, N. (2019) · Age and Ageing · doi:10.1093/ageing/afz021 · Cited by 180 · see citing works
Mondor, L., Maxwell, C. J., Hogan, D. B., Bronskill, S. E., Gruneir, A., Lane, N. E., & Wodchis, W. P. (2017) · PLOS Medicine · doi:10.1371/journal.pmed.1002249 · Cited by 173 · see citing works
Self-citationKim, D. H., Brown, R. T., Ding, E. L., Kiel, D. P., & Berry, S. D. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03450.x · Cited by 135 · see citing works
Concepts in Practice: Geriatric Emergency Departments
Southerland, L. T., Lo, A. X., Biese, K., et al. (2019) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2019.08.430 · Cited by 118 · see citing works
Use of Services by Community-Dwelling Patients With Dementia: A Systematic Review
Weber, S. R., Pirraglia, P. A., & Kunik, M. E. (2011) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317510392564 · Cited by 86 · see citing works
Griffith, L. E., Gruneir, A., Fisher, K., Panjwani, D., Gandhi, S., Li, S., Gafni, A., Patterson, C., Markle‐Reid, M., & Ploeg, J. (2016) · BMC Geriatrics · doi:10.1186/s12877-016-0351-x · Cited by 86 · see citing works
Gordon, L. B., Waxman, M., Ragsdale, L. C., & Mermel, L. A. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12203 · Cited by 76 · see citing works
Bunn, F., Burn, A., Robinson, L. A., Poole, M., Rait, G., Brayne, C., Schoeman, J., Norton, S., & Goodman, C. M. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013067 · Cited by 73 · see citing works
Quality care for older people with urgent and emergency care needs in UK emergency departments
Banerjee, J., Conroy, S., & Cooke, M. W. (2012) · Emergency Medicine Journal · doi:10.1136/emermed-2012-202080 · Cited by 70 · see citing works
The Transition of Care Between Emergency Department and Primary Care: A Scoping Study
Atzema, C. L., & Maclagan, L. C. (2017) · Academic Emergency Medicine · doi:10.1111/acem.13125 · Cited by 68 · see citing works
Self-citationGupta, A., Jin, G., Reich, A. J., Prigerson, H. G., Ladin, K., Kim, D. H., Ashana, D. C., Cooper, Z. R., Halpern, S. D., & Weissman, J. S. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16683 · Cited by 45 · see citing works
Chen, R., Chien, W., Kao, C., Chung, C., Liu, D., Chiu, H., & Chou, K. (2018) · Alzheimer s Research & Therapy · doi:10.1186/s13195-018-0437-0 · Cited by 38 · see citing works
Bronskill, S. E., Maclagan, L. C., Walker, J. D., Guan, J., Wang, X., Ng, R., Rochon, P. A., Yates, E. A., Vermeulen, M. J., & Maxwell, C. J. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-037485 · Cited by 35 · cited 1× · see citing works
“Compared with other older adults, individuals living in the community with dementia use more health services across a variety of provider types including primary care, specialist care, home care, and the emergency department (ED).(1,2) Although EDs provide essential care for urgent health concerns, they are generally…”
BackgroundSelf-citationMoe, J., O’Sullivan, F., McGregor, M. J., Schull, M. J., Dong, K. A., Holroyd, B. R., Grafstein, E., Hohl, C. M., Trimble, J., & McGrail, K. M. (2021) · CMAJ Open · doi:10.9778/cmajo.20200168 · Cited by 34 · see citing works
Self-citationAssociation of dementia diagnosis with urinary tract infection in the emergency department
Yourman, L. C., Kent, T., Israni, J., et al. (2020) · Journal of the American College of Emergency Physicians Open · doi:10.1002/emp2.12268 · Cited by 25 · see citing works
Identifying subgroups and risk among frequent emergency department users in British Columbia
Moe, J., O’Sullivan, F., McGregor, M. J., Schull, M. J., Dong, K. A., Holroyd, B. R., Grafstein, E., Hohl, C. M., Trimble, J., & McGrail, K. M. (2021) · Journal of the American College of Emergency Physicians Open · doi:10.1002/emp2.12346 · Cited by 20 · see citing works
Self-citationTransition of Care from the Emergency Department to the Outpatient Setting: A Mixed-Methods Analysis
Rider, A. C., Kessler, C. S., Schwarz, W. W., Schmitz, G., Oh, L. Y., Smith, M. J., Gross, E., House, H. R., Wadman, M. C., & Lo, B. (2018) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2017.9.35138 · Cited by 16 · see citing works
Predictors of return visits to the emergency department among different age groups of older adults
Oliveira J. e Silva, L., Jeffery, M. M., Campbell, R. L., Mullan, A. F., Takahashi, P. Y., & Bellolio, F. (2021) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2020.07.042 · Cited by 16 · see citing works
Physician Home Visit Patterns and Hospital Use Among Older Adults with Functional Impairments
Jones, A., Bronskill, S. E., Seow, H. Y., et al. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16639 · Cited by 15 · see citing works
Self-citationEmergency department information system diagnosis: how accurate is it?
Mitchell, J. S., & Westerduin, F. (2008) · Emergency Medicine Journal · doi:10.1136/emj.2007.050104 · Cited by 12 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Jones, A., Watt, J. A., Maclagan, L. C., Swayze, S., Jaakkimainen, L., Schull, M. J., & Bronskill, S. E. (2023) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18457 · Cited by 8 · see citing works
Self-citation
- Authors
- Jones, A., Maclagan, L. C., Watt, J. A., Schull, M. J., Jaakkimainen, L., Swayze, S., Guan, J., & Bronskill, S. E.
- Affiliations
- Institute for Clinical Evaluative Sciences (CA)
- St. Michael's Hospital (CA)
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Jones, Aaron
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2022-03-03
- Volume
- 70
- Issue
- 6
- Pages
- 1745-1753
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W4214857056
- Semantic Scholar
- c391a9ab5e228a1dff7ce707d6d9688b8f75d046
- Cited by
- 16
- References
- 27
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 7 · 2022: 3
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Alzheimer Society (21‐18)
- Institute for Clinical Evaluative Sciences
- Ontario Brain Institute (Ontario Neurodegenerative Disease Research Initiative (ONDRI))
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- dementia, emergency department visits, community-dwelling older adults, reasons for emergency visits, primary care
- MeSH terms
- Aged, Dementia, Emergency Service, Hospital, Humans, Ontario, Retrospective Studies, Independent Living
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
