Risk factors and interventions for developing recurrent pneumonia in older adults

Takada, Kazufumi; Ogawa, Kazumasa; Miyamoto, Atsushi; Nakahama, Hiroshi; Moriguchi, Shuhei; Murase, Kyoko; Hanada, Shigeo; Takaya, Hisashi; Tamaoka, Meiyo; Takai, Daiya

doi:10.1183/23120541.00516-2022

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…This is why we previously proposed the term 'Frailty associated pneumonia (FAP)' [13]. Some reported poor prognostic factors include multimorbidity, aspiration, reduced cough effectiveness, malnutrition, older age, higher dependency, loss of muscle mass and anticholinergic drugs [12][13][14][15][16][17][18][19][20][21][22][23][24]. No clear prognostic factors have been identified for pneumonia in older adults, despite the high disease prevalence and mortality.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors of poor outcomes in pneumonia in older adults: aspiration or frailty?

Yoshimatsu,

Thomas,

Thompson

et al. 2024

Eur Geriatr Med

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Purpose Little is known about the long-term and functional prognoses of older adults with pneumonia, which complicates their management. There is a common belief that aspiration is a poor prognostic factor; however, the diagnosis of aspiration pneumonia (AP) lacks consensus criteria and is mainly based on clinical characteristics typical of the frailty syndrome. Therefore, the poor prognosis of AP may also be a result of frailty rather than aspiration. This study investigated the impact of AP and other prognostic factors in older patients with pneumonia. Methods We performed a retrospective cohort study of patients aged 75 years and older, admitted with pneumonia in 2021. We divided patients according to their initial diagnosis (AP or non-AP), compared outcomes using Kaplan–Meier curves, and used logistic regression to identify independent prognostic factors. Results 803 patients were included, with a median age of 84 years and 52.7% were male. 17.3% were initially diagnosed with AP. Mortality was significantly higher in those diagnosed with AP than non-AP during admission (27.6% vs 19.0%, p = 0.024) and at 1 year (64.2% vs 53.1%, p = 0.018), with survival analysis showing a median survival time of 62 days and 274 days in AP and non-AP, respectively (χ2 = 9.2, p = 0.002). However, the initial diagnosis of AP was not an independent risk factor for poor prognosis in multivariable analysis. Old age, frailty and cardio-respiratory comorbidities were the main factors associated with death. Conclusion The greater mortality in AP may be a result of increased frailty rather than the diagnosis of aspiration itself. This supports our proposal for a paradigm shift from making predictions based on the potentially futile labelling of AP or non-AP, to considering frailty and overall condition of the patient.

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Section: Introductionmentioning

confidence: 99%

Prognostic factors of poor outcomes in pneumonia in older adults: aspiration or frailty?

Yoshimatsu,

Thomas,

Thompson

et al. 2024

Eur Geriatr Med

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Pneumonia in Geriatric Patients: Focus on Etiology, Clinical Features, Diagnosis, and Prevention

Tomys-Składowska,

Lamch,

Jabłońska

et al. 2023

Journal of Health Study and Medicine

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Background Pneumonia remains a frequent respiratory disease that occurs in people of all ages; however, its impact is particularly significant in geriatric population. It leads to severe complications and increased mortality rates. The clinical features in the elderly may be atypical, thus causing difficulties in the diagnostic process and possible treatment delays. Aim of the study The study was designed to provide an overview of pneumonia, focusing on differences in the clinical picture, diagnosis, and prevention in the elderly. Material and Methods The article is based on 51 articles published between 2008 and 2023, found in electronic databases Google Scholar and PubMed. Results Age-related changes in immune and respiratory systems such as impaired cough reflex, reduced lung function, or lower immune cell production lead to increased susceptibility to infections. Comorbidities, including chronic obstructive pulmonary disease, diabetes mellitus, and heart diseases, increase the risk of pneumonia significantly. Radiographic examinations and laboratory tests are useful tools in differentiating pneumonia from other conditions. Vaccination is proven to perform a crucial role in pneumonia prevention. Conclusions This review synthesizes the existing knowledge of pneumonia in the elderly including epidemiology, risk factors, symptoms, and management. By enhancing the understanding of pneumonia in geriatric patients, healthcare professionals are able to improve diagnostic accuracy and tailor treatment strategies to reduce the burden of the disease.

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Risk factors and interventions for developing recurrent pneumonia in older adults

Cited by 2 publications

References 40 publications

Prognostic factors of poor outcomes in pneumonia in older adults: aspiration or frailty?

Prognostic factors of poor outcomes in pneumonia in older adults: aspiration or frailty?

Pneumonia in Geriatric Patients: Focus on Etiology, Clinical Features, Diagnosis, and Prevention

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