Beauchet Olivier, Matskiv Jacqueline, Launay Cyrille P, Rolland Yves, Schott Anne-Marie, Allali Gilles
Department of Medicine and Geriatrics, University of Montreal, Montreal, QC, Canada.
Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada.
Front Aging Neurosci. 2022 Jul 22;14:912477. doi: 10.3389/fnagi.2022.912477. eCollection 2022.
"Emergency Room Evaluation and Recommendations" (ER) risk levels (i.e., low, moderate and high) may be used to screen for major neurocognitive disorders (MNCD) in older emergency department users, as a high ER risk level is associated with MNCD diagnosis. This study aims to examine the association of ER risk levels with incident MNCD in community-dwelling older adults.
A total of 709 participants of the EPIDémiologie de l'OStéoporose (EPIDOS) study-an observational population-based cohort study-were recruited in Toulouse (France). ER low, moderate and high risk levels were determined at baseline. Incident MNCD and their type (i.e., Alzheimer's disease (AD) vs. non-AD) were diagnosed after a 7-year follow-up period.
The overall incidence of MNCD was 29.1%. A low ER risk level was associated with low incidence of MNCD [Hazard ratio (HR) = 0.71 with = 0.018] and AD (HR = 0.56 with = 0.003), whereas a high risk level, both individually and when combined with a moderate risk level, was associated with high incidence of MNCD (HR ≥ 1.40 with ≤0.018) and AD (HR ≥ 1.80 with ≤ 0.003). No association was found with incident non-AD.
ER risk levels were positively associated with incident MNCD in EPIDOS participants, suggesting that ER may be used for risk screening of MNCD in the older population.
“急诊室评估与建议”（ER）风险水平（即低、中、高）可用于筛查老年急诊患者中的主要神经认知障碍（MNCD），因为高ER风险水平与MNCD诊断相关。本研究旨在探讨ER风险水平与社区居住的老年人中MNCD发病的关联。
在法国图卢兹招募了骨质疏松症流行病学（EPIDOS）研究的709名参与者，这是一项基于人群的观察性队列研究。在基线时确定ER低、中、高风险水平。在7年随访期后诊断出MNCD发病及其类型（即阿尔茨海默病（AD）与非AD）。
MNCD的总体发病率为29.1%。低ER风险水平与MNCD低发病率相关[风险比（HR）=0.71，P = 0.018]和AD（HR = 0.56，P = 0.003），而高风险水平，无论是单独还是与中等风险水平组合时，都与MNCD高发病率相关（HR≥1.40，P≤0.018）和AD（HR≥1.80，P≤0.003）。未发现与非AD发病有关联。
在EPIDOS参与者中，ER风险水平与MNCD发病呈正相关，表明ER可用于老年人群中MNCD的风险筛查。
