A Prospective Study of Age and Lifestyle Factors in Relation to Community-Acquired Pneumonia in US Men and Women

Baik, Inkyung; Curhan, Gary C.; Rimm, Eric B.; Bendich, Adrianne; Willett, Walter C.; Fawzi, Wafaie W.

doi:10.1001/archinte.160.20.3082

Cited by 309 publications

(341 citation statements)

References 50 publications

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“…Steroid exposure has rarely been addressed as a potential risk factor for pneumonia in the general population (38)(39)(40)(41)44). To our knowledge, glucocorticoid dosage has not been demonstrated to be predictive of pneumonia risk in any previous study.…”

Section: Discussionmentioning

confidence: 80%

“…The pathophysiologic explanation for this finding is, however, incompletely understood. A number of studies have also established smoking history as a risk factor for pneumonia (42)(43)(44)(45).The relevant mechanisms that have been proposed include decreased ciliary and respiratory epithelial function, as well as defects in cellular and humoral immunity (44,46). Interestingly, smoking entered the univariate model (Table 3), but was not predictive by multivariate analysis (Table 5) because of its correlation with preexisting pulmonary disease (which it may have caused).…”

Section: Discussionmentioning

confidence: 99%

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Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: Associations with prednisone, disease‐modifying antirheumatic drugs, and anti–tumor necrosis factor therapy

Wolfe¹,

Caplan²,

Michaud³

2006

Arthritis & Rheumatism

423

233

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Objective. Pneumonia is a major cause of mortality and morbidity in rheumatoid arthritis (RA). This study was undertaken to determine the rate and predictors of hospitalization for pneumonia and the extent to which specific RA treatments increase pneumonia risk.Methods. RA patients (n ‫؍‬ 16,788) were assessed semiannually for 3.5 years. Pneumonia was confirmed by medical records or detailed patient interview. Covariates included RA severity measures, diabetes, pulmonary disease, and myocardial infarction. Cox proportional hazards regression was used to determine the multivariable risk associated with RA treatments.Results Conclusion. There is a dose-related relationship between prednisone use and pneumonia risk in RA. No increase in risk was found for anti-tumor necrosis factor therapy or methotrexate. These data call into question the belief that low-dose prednisone is safe. Because corticosteroid use is common in RA, the results of this study suggest that prednisone exposure may have important public health consequences.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: Associations with prednisone, disease‐modifying antirheumatic drugs, and anti–tumor necrosis factor therapy

Wolfe¹,

Caplan²,

Michaud³

2006

Arthritis & Rheumatism

423

233

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“…A radiology report of a pulmonary infiltrate confirmed the presence of pneumonia in 82 percent of the cases. [3] After the first two years of this study, medical records were obtained from all women who reported radiologically diagnosed pneumonia. After reviewing records from a sample of 99 confirmed cases, only one was potentially hospital-acquired.…”

Section: Identification Of Cases Of Pneumoniamentioning

confidence: 99%

“…Risk factors for pneumonia include smoking, chronic obstructive pulmonary disease, alcohol abuse, and age. [3] Surprisingly, little research exists on the dietary risk factors that may impact on community-acquired pneumonia risk other than malnutrition. [3][4][5] Essential fatty acids (alpha-linolenic and linoleic acids), non-essential fatty acids (palmitic and oleic acids), eicosapentanoic acid or EPA, and docosahexanoic acid or DHA may impact the risk of community-acquired pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Fatty acid intake and the risk of community-acquired pneumonia in U.S. women

Alperovich¹,

Neuman

Willett

et al. 2007

Nutrition

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Objective-Despite substantial progress in the treatment of community-acquired pneumonia, there are limited data on dietary risk factors. Fatty acid intake may influence community-acquired pneumonia risk by modulating the immune system. Our study prospectively examined the association between fatty acid intake and community-acquired pneumonia risk.Research Methods & Procedures-The study population included 83,165 women from the Nurses' Health Study II cohort who were between the ages of 27 and 44 in 1991. The women reported lifestyle habits on biennial questionnaires and dietary intake every four years by validated semiquantitative food frequency questionnaires (FFQ). There were 925 pneumonia cases over 10 years of follow-up. We examined independent associations for six fatty acids using Cox proportional hazards regression.Results-Women in the highest quintile of palmitic acid intake had a 54% greater risk of pneumonia compared to the lowest quintile: multivariate relative risk (RR)=1.54; 95% confidence interval (CI): 1.12, 2.12; p for trend = 0.002. Oleic acid intake was inversely associated with pneumonia risk (highest quintile multivariate RR=0.75; 95% CI: 0.55, 1.04; p for trend = 0.02). Women in the highest quintile of docosahexanoic acid (DHA) and eicosapentanoic acid (EPA) intake had a 24% greater risk of community-acquired pneumonia than the lowest quintile (multivariate RR=1.24; 95% CI: 1.00, 1.55; p for trend = 0.08). No significant associations were found for linoleic acid, alpha-linolenic acid, or DHA alone.Conclusions-Fatty acid intake may affect the risk of community-acquired pneumonia in young and middle-aged women. Higher dietary intake of palmitic acid and possibly DHA and EPA may increase the risk of community-acquired pneumonia in women while higher oleic acid intake may decrease the risk.

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“…heart, renal and lung diseases, low body mass index [BMI] and previous respiratory infection) and environmental factors (e.g. second-hand smoke and exposure to gases, fumes and chemicals) [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Poor Oral Health as Risk Factor for Community-Acquired Pneumonia

Rodríguez¹,

Bolíbar²,

Serra‐Prat³

et al. 2014

J Pulm Respir Med

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Objectives: Considerable evidence exists of the relationship between poor oral hygiene (therefore greater presence of plaque) and risk of pneumonia in special-care populations, including intensive care unit and nursing home settings. However, the effect of poor oral health on the development of community-acquired pneumonia (CAP) remains to be established. We assessed the relationship between CAP and oral health in general adult population. Study design:Over 1-year period, 1,336 incident cases of CAP and 1,326 controls were enrolled in a populationbased case-control study. A questionnaire on CAP risk factors that included oral health-related questions, including visit to dentist in the last month, bleeding gums, gingivitis, dental dysaesthesia, dental prosthesis, gumboil in the last month, teeth move or lost, and periodontal disease was administered to all participants. Results:The prevalence of dental dysaesthesia and use of dental prosthesis was significantly higher among patients with CAP than in control subjects (23.3% vs. 19.7%, P = 0.043, and 45.6% vs. 40.8%, P = 0.016, respectively), whereas visit to the dentist in the last month was a preventive factor against the development of CAP (odds ratio 0.71, 95% confidence interval 0.55-0.92, P = 0.008). Results of bivariate analysis were confirmed in the adjusted multivariate logistic regression models. Conclusions:Poor oral health may contribute to a higher risk for CAP in adult patients. Oral hygiene practices are particularly important in subjects with dental dysaesthesia and dental prosthesis. Not only odontologists but also dental hygienists should be aware of the relationship between oral health and potentially severe lung infection.

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A Prospective Study of Age and Lifestyle Factors in Relation to Community-Acquired Pneumonia in US Men and Women

Abstract: Smoking and excessive weight gain are risk factors for CAP among men and women, and physical activity was inversely associated with risk of CAP only among women. The incidence of CAP could possibly be decreased by lifestyle factors.

Cited by 309 publications

References 50 publications

Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: Associations with prednisone, disease‐modifying antirheumatic drugs, and anti–tumor necrosis factor therapy

Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: Associations with prednisone, disease‐modifying antirheumatic drugs, and anti–tumor necrosis factor therapy

Fatty acid intake and the risk of community-acquired pneumonia in U.S. women

Poor Oral Health as Risk Factor for Community-Acquired Pneumonia

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