Epidemiology of Depression, Anxiety, and Cognitive Impairment

• Depression by PHQ9 [ Time Frame: 2 hours ] [ Designated as safety issue: No ]
  
• Cognitive Impairment by Six Item Screener [ Time Frame: 2 hours ] [ Designated as safety issue: No ]
  
• Anxiety by GAD-7 [ Time Frame: 2 hours ] [ Designated as safety issue: No ]
  

• Reliability of each measure at 2 weeks, 6 months. [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  

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:

1. 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.
2. Evaluate the reliability of screening patients for depression and cognitive impairment during an acute illness and after the illness.
3. 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.