Pneumonia is a major direct cause of death in the elderly. Although aspiration based on a reduced cough reflex is one of the causes of pneumonia in the elderly, there are few studies of angiotensin-I converting enzyme inhibitors (ACE inhibitors), which are antihypertensive drugs that induce cough, as a factor influencing the incidence of pneumonia in institutionalized elderly subjects. To assess the effect of ACE inhibitors and dihydropiridine calcium-channel blockers on the incidence of pneumonia, we conducted a hospital-based case-control study. Cases were 55 pneumonia patients aged > or = 65 years during a 1-year period. The controls were elderly subjects, frequency matched to the cases by age and gender (n = 220). Data were collected on known risk factors and on medication for hypertension, consisting of ACE inhibitors, calcium-channel blockers, and nonantihypertensive medication. The significance of differences in risk factors was analyzed using univariate and multivariate comparisons of cases and controls. After adjustment for potential confounding factors, the relative risk estimates for pneumonia were 0.38 (95% confidence interval [CI], 0.15-0.97) and 1.84 (95% CI, 0.89-3.78) for ACE inhibitors and calcium-channel blockers, respectively, relative to nonantihypertensive medication. The preventive effect of ACE inhibitors on pneumonia was apparent in long-acting ACE inhibitor users (0.24; 95% CI, 0.07-0.88). We conclude that ACE inhibitor use is an independent factor reducing risk of pneumonia among elderly inpatients.

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These results suggest that use of an ACE inhibitor is beneficial for reducing risk of pneumonia, particularly in individuals with the ACE genotypes ID + II.

Background: The purpose of the present paper was to determine clinical risk factors for the development of pressure ulcers in bedridden elderly inpatients. Methods: A case‐control study was performed for 117 subjects with pressure ulcers (mean age: 80.6 ± 7.2 years) with a 1‐year observation period, and 351 age‐ and sex‐matched controls. Factors examined were subitems of the Braden scale; convenient clinical assessment (continence, sitting, turning, oral intake, and sitting up); underlying chronic conditions (stroke and diabetes mellitus); and circulating levels of albumin, total cholesterol, total lymphocyte count, and hemoglobin. Results: Compared to the controls, test cases showed lower scores of the Braden scale and lower levels of circulating factors, and higher incidences of incapability of the subitems of convenient clinical assessment, and of diabetes mellitus (P < 0.20). Three models of multiple logistic regression analysis revealed that decreased serum level of albumin and impaired self‐positioning in bed were significant independent risk factors. The relative risk for the development of pressure ulcers after full adjustment in the group with both hypoalbuminemia (< 35 g/L) and incapability of turning over in bed, the group with the former risk alone, and the group with the latter risk alone, was 14.0 (95% confidence interval (CI): 4.2–46.6), 4.9 (1.6–14.9), and 5.9 (1.8–19.0), respectively, compared to subjects without the two risk factors. Moreover, decreased circulating levels of albumin and hemoglobin were associated with aggravation of pressure ulcers. Conclusion: A combined measure of albumin and incapability of self‐positioning may serve as a simple but useful index for the risk of pressure ulcers in bedridden elderly inpatients.

The object of this study was to examine blood pressure (BP) variability due to postural change in elderly hypertensive patients. The subjects studied were 154 elderly inpatients in a hospital for the elderly (48 male and 106 female; median age: 82 years), consisting of age-and sex-matched bedridden (n =39) and non-bedridden (n =39) normotensive controls and bedridden (n =38) and non-bedridden (n =38) hypertensive patients. BP and pulse rate (

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Obstructive, central and mixed SAS were associated with increased risk of cardiovascular related and all-cause mortality. Mixed SAS was associated with an increase in mortality from pneumonia. There was no relationship between mortality and severity of SAS.