Loss of oral self‐care ability results in a higher risk of pneumonia in older inpatients: A prospective cohort study in a Japanese rural hospital

Abstract

Objectives To identify significant risk factors associated with incidence of mortality and pneumonia in whole‐community‐based older inpatients resident in Japanese rural region. Methods Patients older than 65 years admitted between 1 April and 15 April 2010 to a core hospital located in a rural region were exhaustively recruited, and incidence of mortality and pneumonia during the 32‐month follow‐up period were evaluated. Independent variables at baseline measurement included age, gender, body mass index, Charlson comorbidity index, functional dependency, oral self‐care ability index, number of remaining teeth, hyposalivation and nutritional status. Dependent variables were incidence of mortality and pneumonia. Survival and non‐pneumonia curves were drawn using Kaplan‐Meier analysis. Cox proportional hazards analysis was performed to identify the risk factors related to incidence of mortality and pneumonia. Results The survival rate of 46 patients (male/female: 11/35; mean age: 83.8 ± 6.8 years) was 52.1%, and the incidence of pneumonia was 60.9%. Malnutrition and gender (male) were identified as significant risk factors for mortality (odds ratio [OR]: 8.18 and 4.90; 95% confidence interval [CI]: 1.77‐37.3 and 1.50‐16.0; P < 0.01 and <0.01, respectively). Loss of oral self‐care ability and gender (male) were identified as significant risk factors for incidence of pneumonia (OR: 8.97 and 4.58; 95% CI: 1.70‐47.4 and 1.50‐14.0; P = 0.01 and <0.01, respectively). Conclusions Malnutrition and loss of oral self‐care ability were significant risk factors for incidence of mortality and pneumonia, respectively. In response, supplying nutrition with appropriate diet and personalised oral care might contribute to reduction in mortality and prevention of pneumonia.

Effect of Nutritional Intervention Programs on Nutritional Status and Readmission Rate in Malnourished Older Adults with Pneumonia: A Randomized Control Trial

“…Malnutrition leads to the development of pneumonia and weakens the physical activity and immune system [5]. Therefore, adequate nutrition directly aids respiratory muscle function and immune defense mechanisms and provides high immunity against environmental pathogens in the lungs to reduce potential disease progression [6,7]. Therefore, the major role of nutrition in alleviating pneumonia is reducing malnutrition that induces high mortality and morbidity [8,9] and maintaining impaired respiratory muscle contractility [10].…”

Effect of Poor Nutritional Status and Comorbidities on the Occurrence and Outcome of Pneumonia in Elderly Adults

“…Adequate nutrition can enhance respiratory muscle function and immune defense ( 28 , 29 ). Therefore, nutritional intervention can control disease progression and improve respiratory function, thus reducing morbidity and mortality ( 30 ), hospitalization costs, and re-hospitalizations ( 31 , 32 ). Albumin level below 3.5 mg/dL suggests a poor nutritional status and survival ( 33 ).…”

Food Preferences and Nutritional Status: Insights on Nutrition Transition in University Community

“…A key determinant of child malnutrition is socioeconomic vulnerability. Southeast Asia and Africa report that the incidence of malnutrition among girls has risen regularly in contrast to boys (Fujiwara et al, 2019). For example, Bangladesh research has shown a higher rate of malnutrition (54 percent) among females and a higher risk (1,44 times) of malnutrition compared to males (Zysman et al, 2019).…”