Carpenter CR, et al. - Researchers performed this systematic review and meta-analysis to assess the diagnostic accuracy of sufficiently brief screening instruments for dementia in Geriatric Emergency Department (ED) patients. Further, they defined an evidence-based pretest probability of dementia based on published research and then estimated disease thresholds at which dementia screening is most appropriate. They identified a total of 1,616 publications, of which 16 underwent full text-review; nine studies were included with a weighted average dementia prevalence of 31% (range, 12%–43%). This suggests the limitation of ED-based diagnostic research for dementia to a few studies using an inadequate criterion standard with variable masking of interpreter's access to the index test and the criterion standard. The necessity for standardizing the geriatric ED cognitive assessment methods, measures, and nomenclature was thus suggested to reduce uncertainties about diagnostic accuracy, reliability, and relevance in this acute care setting. Currently, the Abbreviated Mental Test (AMT-4) was identified as the most accurate ED screening instrument to increase the probability of dementia and the Brief Alzheimer's Screen as the most accurate to decrease the probability of dementia. Test–treatment threshold calculations support dementia screening as one marker of vulnerability to initiate comprehensive geriatric assessment.