Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 May;21(5):e70287.
doi: 10.1002/alz.70287.

Novel algorithms & blood-based biomarkers: Dementia detection and care transitions for persons living with dementia in the emergency department

Saket Saxena  1   2 , Christopher Carpenter  3 , Darlene P Floden  4 , Stephen Meldon  2 , R Andrew Taylor  5   6   7 , Ula Hwang  8   9
Affiliations
Review

Novel algorithms & blood-based biomarkers: Dementia detection and care transitions for persons living with dementia in the emergency department

Saket Saxena et al. Alzheimers Dement. 2025 May.

Abstract

Persons Living with Dementia (PLWD), diagnosed or undiagnosed, have high Emergency Department (ED) use. Identification of such patients poses significant challenges for emergency clinicians with considerable downstream implications on patients, care partners, and healthcare systems. With the advent of Geriatric Emergency Departments (GEDs) there is an opportunity to understand and improve care of PLWDs in EDs with effective allocation of resources and the development of novel techniques to better support detecting those at risk, communicating findings, and coordinating care for such patients. Advances have been made leveraging Electronic Health Record (EHR) data to risk stratify patients for dementia in the hope that those at high-risk may benefit from further evaluation. The promise of multiple blood-base biomarkers (BBM) as a future modality to improve detection of those at risk of dementias, will also have the potential to advance the delivery of care of PLWD and their care partners in EDs. HIGHLIGHTS: EDs have an integral role in delivering care for Person Living with Dementia and their care partners. High acuity and fast paced ED environment and other barriers makes it difficult to identify Person Living with Dementia. EHR-based risk stratification algorithms can identify patients at risk for Dementia in ED and outpatient settings. Use of Blood-Based Biomarkers in the ED setting is novel and considerations of its use and implications need to be studied. EHR based risk stratification algorithm and Blood Based Biomarkers when used judiciously have the potential to overcome some of the known barriers to identify and improve care for Person Living with Dementia as they transition through EDs.

Keywords: algorithms; blood based biomarkers; dementia; detection; emergency department; geriatrics.

PubMed Disclaimer

Conflict of interest statement

Saket Saxena: DAVOS Alzheimer's Collaborative (DAC), R61AG069729; R33AG069729. Christopher Carpenter: Associate Editor for the Journal of the American Geriatrics Society, Deputy Editor‐in‐Chief Academic Emergency Medicine, leads the Society for Academic Emergency Medicine Guidelines for Reasonable and Appropriate Care in the Emergency Department committee, serves on the American College of Emergency Physicians Clinical Policy Committee, is Chair of the American College of Emergency Physician's Geriatric Emergency Department Accreditation Advisory Board, serves on the Clinician‐Scientist Transdisciplinary Aging Research Leadership Core, and is an editor for the American College of Emergency Physician's MyEMCert program. R33 AG069822; R33 AG058926. Darlene P. Floden: R61AG069729; R33AG069729. Stephen Meldon: None. R. Andrew Taylor: P30 AG073104. Ula Hwang: R33 AG069822; R33 AG058926; P30 AG073104. Author disclosures are available in the Supporting Information.

Figures

FIGURE 1
FIGURE 1
ED visits before and after first dementia diagnosis. ED, emergency department.
FIGURE 2
FIGURE 2
GEAR 2.0 properties for PLWD and impact of novel algorithms and blood‐based biomarkers. ED‐emergency department; EHR‐electronic health record; GEAR, geriatric emergency care applied research; PLWD, persons living with dementia.
FIGURE 3
FIGURE 3
Multi‐level complexities of ED communication. ED‐emergency department.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Lin PJ, Daly AT, Olchanski N, et al. Dementia diagnosis disparities by race and ethnicity. Med Care. 2021;59(8):679‐686. - PMC - PubMed
    1. Shah MN, Hwang U. Recurrent emergency department visits among persons living with dementia: bending the curve. J Am Geriatr Soc. 2023;71(12):3676‐3679. - PMC - PubMed
    1. LaMantia MA, Stump TE, Messina FC, Miller DK, Callahan CM. Emergency department use among older adults with dementia. Alzheimers Dement. 2016;30(1):35‐40. - PMC - PubMed
    1. Adams G, Hoffman JW, Goldberg EM. It's time for an overhaul of emergency department operations for people living with dementia. J Public Health Emerg. 2024;8:12.
    1. Kent T, Lesser A, Israni J, Hwang U, Carpenter C, Ko K. 30‐day emergency department revisit rates among older adults with documented dementia. J Am Geriatr Soc. 2019;67(11):2254–2259. doi:10.1111/jgs.16114 - DOI - PMC - PubMed