Emergency Room Evaluation and Recommendations and Risk Screening of Incident Major Neurocognitive Disorders in Older Females: Results of an Observational Population-Based Cohort Study

BACKGROUND: “Emergency Room Evaluation and Recommendations” (ER(2)) 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(2) risk level is associated with MNCD diagnosis. This study aims to examine the association of ER(2) risk levels with incident MNCD in community-dwelling older adults. METHODS: 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(2) 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. RESULTS: The overall incidence of MNCD was 29.1%. A low ER(2) risk level was associated with low incidence of MNCD [Hazard ratio (HR) = 0.71 with P = 0.018] and AD (HR = 0.56 with P = 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 P ≤0.018) and AD (HR ≥ 1.80 with P ≤ 0.003). No association was found with incident non-AD. CONCLUSION: ER(2) risk levels were positively associated with incident MNCD in EPIDOS participants, suggesting that ER(2) may be used for risk screening of MNCD in the older population.