{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T05:25:14Z","timestamp":1793856314871,"version":"4.6.1"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:00:00Z","timestamp":1793750400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000143","name":"Alzheimer Society","doi-asserted-by":"publisher","award":["0000000049"],"award-info":[{"award-number":["0000000049"]}],"id":[{"id":"10.13039\/501100000143","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020851","name":"Research Institute for Aging, University of Waterloo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020851","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living with dementia frequently present to emergency departments (EDs) and are at increased risk of hospitalization, institutionalization, and other adverse outcomes. Geriatric Emergency Management (GEM) programs are designed to improve emergency care for older adults, but their effectiveness among people living with dementia remains uncertain. We evaluated the association between attendance at an ED with an active GEM program and days alive and at home among older adults living with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population\u2010based retrospective cohort of Ontario residents aged 65\u2009years or older with identified dementia who had an index ED visit between April 1, 2021, and March 31, 2024. The exposure was attendance at an ED with an active GEM program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 145,874 individuals, including 110,288 who presented to EDs with GEM programs and 35,586 who presented to EDs without GEM programs. The median age of the population was 81\u2009years and 58.5% of participants were female. After propensity score overlap weighting and adjustment for facility characteristics, individuals who visited GEM EDs spent 7.5 (95% CI, 3.1\u201312.0) more days alive and at home during the following year than those who visited non\u2010GEM EDs. Approximately half of this difference was attributable to fewer days spent in long\u2010term care homes. Visits to GEM EDs were also associated with fewer subsequent ED visits, although index ED length of stay and hospital admission rates were higher.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Among older adults living with dementia, care in EDs with GEM programs was associated with more days alive at home over the following year. These findings support continued investment in GEM programs to promote aging at home and to delay institutionalization among people living with dementia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70437","type":"journal-article","created":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:43:36Z","timestamp":1793853816000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Geriatric Emergency Management Programs and Days at Home Among People Living With Dementia in Ontario"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8832-7697","authenticated-orcid":false,"given":"Margret","family":"Lo","sequence":"first","affiliation":[{"name":"Michael G. DeGroote School of Medicine  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-5346","authenticated-orcid":false,"given":"James","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Bagley","sequence":"additional","affiliation":[{"name":"St Joseph's Health System  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humberto","family":"Omana","sequence":"additional","affiliation":[{"name":"Regional Geriatric Program of Southwestern Ontario  London Ontario Canada"},{"name":"St. Joseph's Health Care London  London Ontario Canada"},{"name":"School of Health Studies Western University  London Ontario Canada"},{"name":"Lawson Research Institute  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8844-5850","authenticated-orcid":false,"given":"Fabrice","family":"Mowbray","sequence":"additional","affiliation":[{"name":"College of Nursing Michigan State University  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Bielska","sequence":"additional","affiliation":[{"name":"Institute of Public Health Jagiellonian University  Krakow Poland"},{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7341-0655","authenticated-orcid":false,"given":"Susan","family":"Bronskill","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don","family":"Melady","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Schwartz\u2010Reisman Emergency Medicine Institute Mount Sinai Hospital, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5875-2211","authenticated-orcid":false,"given":"Kelly","family":"Kay","sequence":"additional","affiliation":[{"name":"Provincial Geriatrics Leadership Ontario  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Lapointe\u2010Shaw","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"},{"name":"Division of General Internal Medicine and Geriatrics Sinai Health System and The University Health Network  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Watt","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Division of Geriatric Medicine St. Michael's Hospital, Unity Health Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6282-3614","authenticated-orcid":false,"given":"Aaron","family":"Jones","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Ontario 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