Pseudomonas aeruginosa is an opportunistic pathogen that rarely causes pneumonia in otherwise healthy patients. We describe a case of community-acquired P. aeruginosa pneumonia in a previously healthy individual who likely acquired the infection from a home humidifier.
Background
Asthma’s impact on functional limitations of older adults in the United States has not been fully described.
Design
Analyses were conducted with data from the Asthma Beliefs and Literacy in the Elderly (ABLE) study, a prospective cohort study of asthmatics aged 60 and older.
Setting
Patients were recruited from urban primary care and pulmonary specialty practices in New York City and Chicago between 2010 and 2012.
Participants
380 women and 72 men, mean age 67.5 years (SD 6.8 range 60–98), 40% Latino, 30% black were included in the study.
Measurements
Characteristics of patients with limitations in activities of daily living (ADLs) were compared to those without ADL limitations using the chi-square test. Generalized estimating equations were used to model the relationships between poor asthma control (Asthma Control Questionnaire [ACQ] score of >1.5) and severity of airway obstruction (Forced Expiratory Volume in one second [FEV1]) and number of limitations of ADLs.
Results
Patients with one or more ADL limitations were more likely to be female (90% vs. 81%, P=0.02), Latino (58% vs. 32%, P<.001), have less than a high school education (53% vs. 27%, P<.001), an income ≤ $1350 per month (79% vs. 46%, P<.001) and be unmarried (78% vs. 64%, P=0.003). In the adjusted analysis, worse ACQ scores (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.0–2.4 P<0.05) but not severity of airway obstruction (OR 1.1, 95% CI 0.6–1.9) was associated with greater ADL limitations.
Conclusion
Older adults reporting poor asthma control are more likely to have limitations in ADLs than those with controlled asthma, though one-time spirometry may not adequately identify those at risk for physical impairment from their asthma.
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