Abstract
Objective
The study objective was to examine whether hospitalization for pneumonia is associated
with functional decline, cognitive impairment, and depression, and to compare this
impairment with that seen after known disabling conditions, such as myocardial infarction
or stroke.
Methods
We used data from a prospective cohort of 1434 adults aged more than 50 years who
survived 1711 hospitalizations for pneumonia, myocardial infarction, or stroke drawn
from the Health and Retirement Study (1998-2010). Main outcome measures included the
number of Activities and Instrumental Activities of Daily Living requiring assistance
and the presence of cognitive impairment and substantial depressive symptoms.
Results
Hospitalization for pneumonia was associated with 1.01 new impairments in Activities
and Instrumental Activities of Daily Living (95% confidence interval [CI], 0.71-1.32)
among patients without baseline functional impairment and 0.99 new impairments in
Activities and Instrumental Activities of Daily Living (95% CI, 0.57-1.41) among those
with mild-to-moderate baseline limitations, as well as moderate-to-severe cognitive
impairment (odds ratio, 2.46; 95% CI, 1.60-3.79) and substantial depressive symptoms
(odds ratio, 1.63; 95% CI, 1.06-2.51). Patients without baseline functional impairment
who survived pneumonia hospitalization had more subsequent impairments in Activities
and Instrumental Activities of Daily Living than those who survived myocardial infarction
hospitalization. There were no significant differences in subsequent moderate-to-severe
cognitive impairment or substantial depressive symptoms between patients who survived
myocardial infarction or stroke and those who survived pneumonia.
Conclusions
Hospitalization for pneumonia in older adults is associated with subsequent functional
and cognitive impairment. Improved pneumonia prevention and interventions to ameliorate
adverse sequelae during and after hospitalization may improve outcomes.
Keywords
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Article Info
Publication History
Published online: March 15, 2013
Footnotes
Funding: This work was supported by Grants KL2 TR000421 , K08 HL091249 , R01 AG030155 , and U01 AG09740 from the National Institutes of Health . The Health and Retirement Study is performed at the Institute for Social Research, University of Michigan.
Conflict of Interest: None. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the National Institutes of Health, or the US government.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
