Abstract. Objective: To determine the test-retest reliability and concurrent criterion validity of a selfreport ED screening questionnaire for adverse outcomes in elders. Methods: A cohort of 1,885 patients aged 265 years were recruited from the EDs of 4 Montreal hospitals. Patients were excluded if they could not be interviewed because of their clinical status or cognitive impairment and no informant was available. The screening questionnaire, administered in the ED, contained 27 items on social, physical, and mental risk factors, medical history, and use of hospital services, medications, and alcohol. A random sample of 404 patients were invited to participate in a clinical assessment 1-3 weeks after the ED visit, that included re-administration of the screening questionnaire, and standardized instruments to assess disability, social resources, depression, alcohol use and abuse, and current medications. Results: Study data were collected from 221 patients (54.7%), of whom 193 were included in the test-retest reliability analyses and 213 i n the analyses of concurrent validity. The concordance correlation coefficient for test-retest reliability of the risk factor score was 0.78 (95% confidence i n t e~a l : 0.71.0.83; n = 193). Several screening questions showed moderately good agreement with the appropriate criterion standard, particularly those on visual and hearing impairment, depression, and use of medications. The best subset of 9 screening questions explained approximately half of the variance in the total disability score. identification of older persons with "sentinel health events" that signal risk of functional deter i o r a t i~n .~.~ Follow-up studies of elders after release from the ED indicate considerable loss of independence,4es substantial rates of hospital admission or death,s and underutilization of appropriate community service^.^ A screening and intervention program, to include the identification of those at risk, followed by referrals to appropriate community services, has the potential to prevent some of these adverse outcomes.Emergency department-based screening programs for elders reported previously reveal high rates of various problems. Gerson and colleaguese assessed the feasibility of a brief comprehensive case-finding program in a multicenter study of ED patients aged 260 years released to their homes. The participation rate was 75% and multiple problems were detected. In a case-finding and liaison service delivered in the ED by a geriatric nurse clinician, 82% of patients aged 2 6 5 years were found to have at least 1 "geriatric" problem and 77% reported at least 1 unmet dental or social support need.7 Although the latter intervention was not effective in reducing mortality or nursing home admissions, members of the intervention group