Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA.
Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
J Am Geriatr Soc. 2024 Nov;72(11):3551-3566. doi: 10.1111/jgs.19052. Epub 2024 Jul 12.
The intersection of ageism and racism is underexplored in geriatric emergency medicine (GEM) research.
We performed a scoping review of research published between January 2016 and December 2021. We included original emergency department-based research focused on falls, delirium/dementia, medication safety, and elder abuse. We excluded manuscripts that did not include (1) original research data pertaining to the four core topics, (2) older adults, (3) subjects from the United States, and (4) for which full text publication could not be obtained. The primary objective was to qualitatively describe reporting about older adults' social identities in GEM research. Secondary objectives were to describe (1) the extent of inclusion of minoritized older adults in GEM research, (2) GEM research about health equity, and (3) feasible approaches to improve the status quo of GEM research reporting.
After duplicates were removed, 3277 citations remained and 883 full-text articles were reviewed, of which 222 met inclusion criteria. Four findings emerged. First, race and ethnicity reporting was inconsistent. Second, research rarely provided a rationale for an age threshold used to define geriatric patients. Third, GEM research more commonly reported sex than gender. Fourth, research commonly excluded older adults with cognitive impairment and speakers of non-English primary languages.
Meaningful assessment of GEM research inclusivity is limited by inconsistent reporting of sociodemographic characteristics, specifically race and ethnicity. Reporting of sociodemographic characteristics should be standardized across different study designs. Strategies are needed to include in GEM research older adults with cognitive impairment and non-English primary languages.
年龄歧视和种族主义在老年急诊医学（GEM）研究中尚未得到充分探讨。
我们对 2016 年 1 月至 2021 年 12 月期间发表的研究进行了范围综述。我们纳入了以急诊部为基础的原创研究，重点关注跌倒、谵妄/痴呆、用药安全和虐待老人。我们排除了未包含以下内容的手稿：（1）与四个核心主题相关的原始研究数据；（2）老年人；（3）来自美国的研究对象；（4）无法获得全文出版的内容。主要目标是定性描述 GEM 研究中老年人社会身份的报告情况。次要目标是描述：（1）少数族裔老年人在 GEM 研究中的纳入程度；（2）GEM 研究中的健康公平问题；（3）改善 GEM 研究报告现状的可行方法。
去除重复项后，剩余 3277 条引文，对 883 篇全文文章进行了回顾，其中 222 篇符合纳入标准。有四个发现。首先，种族和民族报告不一致。其次，研究很少提供用于定义老年患者的年龄阈值的理由。第三，GEM 研究更常报告性别而不是性别。第四，研究通常排除了认知障碍和非英语母语的老年人。
由于社会人口特征（特别是种族和民族）报告不一致，对 GEM 研究包容性的有意义评估受到限制。应在不同的研究设计中标准化社会人口特征的报告。需要制定策略，将认知障碍和非英语母语的老年人纳入 GEM 研究。
