Study Shows Emergency Room Visits Spike Before and After a Dementia Diagnosis

A new diagnosis of dementia is linked to a 40 percent increase in emergency department (ED) visits in the year around a diagnosis, with visits peaking shortly before a person is diagnosed, according to a new analysis published in JAMA Network Open.

“An ED visit can be a significant challenge for persons living with cognitive impairment, their caregivers, and for healthcare professionals—but it can also present an important opportunity to address unmet needs and prevent future ED visits and hospitalizations,” said Ab Brody, PhD, RN, FAAN, the Mathy Mezey Professor of Geriatric Nursing and associate director of HIGN at NYU Rory Meyers College of Nursing and a co-author of the JAMA Network Open study.

“How can we turn an ED visit from a crisis into an opportunity?” added Brody, who is a principal investigator on ED-LEAD, a National Institute on Aging funded clinical trial focused on transforming emergency care for persons living with dementia.

In the study, led by Yale School of Medicine, the researchers analyzed data collected from 2015 to 2021 through the Medicare Current Beneficiary Survey, comparing ED visits from people with and without a dementia diagnosis.

They found that in the six months before a dementia diagnosis, people who were ultimately diagnosed with dementia were slightly less likely to go to the ED than those without a diagnosis (1.7 percent versus 2 percent). However, in the month leading up to a diagnosis, ED visits were far more likely for those living with dementia, at 13 percent versus 2.95 percent. In the month following a dementia diagnosis, the ED visit rate was 3.2 percent, compared with 2.7 percent for those without dementia. Overall, across the 12-month period the researchers assessed, a diagnosis of dementia was linked with a 40 percent increase in the likelihood of an ED visit.

“It’s important to recognize that the spike in ED visits around a dementia diagnosis reveals a critical moment in the diagnostic cascade. These visits often mark the beginning of the journey to diagnosis, offering a great opportunity for healthcare providers to identify cognitive issues early and provide the support that patients and their caregivers really need,” said Cameron Gettel, MD, MHS, assistant professor of emergency medicine at Yale School of Medicine, a co-investigator of the ED-LEAD trial and the study’s lead author.