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AGEM Topic Supplement: Strategies for Inclusion of Diverse Older Adults in Emergency Medicine Research

Volume 5 | Issue 4 | Article 2

Annika R. Bhananker, Michelle Sue, Debra F. Tomasino, Kayla P. Carpenter, Ula Hwang, Christopher R. Carpenter, Sumin Yoon, Dowin Boatright, Cassandra Bradby, Jeffrey Caterino, Andrea Gilmore-Bykovyskyi, Elizabeth M. Goldberg, Maura Kennedy, Shan Liu W, Edgardo Ordonez, Tony Rosen, Margaret E. Samuels-Kalow, Manish Shah, Anița N. Chary

Full Text

Introduction

Older adults account for 20% of emergency department visits in the United States.1 Older adults are commonly defined as aged 65 years and older, although some populations use lower thresholds to account for premature aging; for example, people with HIV and those with a history of incarceration are considered older adults the age of 50.2–8 Substantial efforts are underway across the United States to improve and standardize the process, experience, and outcomes of older adult emergency care. Examples include the American College of Emergency Physician’s Geriatric Emergency Department Accreditation activities and ongoing updates to the 2014 multi-organizational “Geriatric Emergency Department Guidelines” using the GRADE approach to creating clinical practice guidelines.9,10 However, a scoping review of geriatric emergency medicine (EM) research from 2016-2021 found that: (1) few investigations included older adults who speak non-English primary languages, (2) inclusion of older adults from minoritized racial and ethnic groups was inconsistently reported, and (3) few investigations examined racial, gender, cognitive, or geographical disparities in geriatric emergency care.11 Despite knowledge gaps about the health and emergency care of older adults, older adults are routinely excluded from clinical research based on age, cognitive and sensory impairments, and other aging related changes.

Researchers commonly encounter barriers to including older adults in research and lack training to overcome these challenges. At the Society for Academic Emergency Medicine’s 2024 annual conference, 63 emergency medicine researchers and 12 clinician-scientists had a series of roundtable discussions about common challenges and solutions related to inclusion of older adults in emergency care research while incorporating principles of diversity, equity, and inclusion (DEI). Discussions focused on 5 topics based on the scoping review11 and priorities for action and education: (1) general principles for including older adults in EM research, (2) inclusion of older adults with cognitive impairment in EM research, (3) recruitment and retention of socioeconomically disadvantaged older adults, (4) ensuring a diverse research workforce, and (5) incorporating principles of equity into research budgets. Authors discussed and reviewed the notes then created a summary of key strategies for inclusion of diverse older adults in emergency care research, presented in Table 1.

Conclusion

Inclusion of older adults in research is important as we seek to provide high-quality, equitable care to ED patients across the lifespan.11,18–20 We outline common challenges and potential solutions in incorporating older adults, including those with cognitive impairment and those from minority racial and ethnic backgrounds. Intentional planning and collaboration can help address structural barriers to inclusion of diverse populations in emergency care research. As the US population ages, researchers in all fields should strive to include older adults. Geriatric emergency care researchers have unique perspectives and experiences that should be shared with other researchers. Presenting at other society meetings, contributing to journals outside of geriatric emergency medicine, and collaborating with non-geriatric emergency medicine researchers may help disseminate best practices regarding the inclusion of older adults in research.

REFERENCES

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    10/17/2024 Topic Supplement 6 | Page © Advocate Health 2024
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