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Dementia, lower respiratory tract infection, and long-term mortality.
- Source :
-
Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2007 Jul; Vol. 8 (6), pp. 396-403. Date of Electronic Publication: 2007 Jun 14. - Publication Year :
- 2007
-
Abstract
- Objective: To examine long-term mortality and its determinants in nursing home residents with dementia diagnosed with a lower respiratory tract infection (LRI).<br />Setting and Patients: US (Missouri) nursing home residents (541) and Dutch residents (403) with dementia who were treated with antibiotics for an LRI.<br />Methods: Prospective studies of nursing home-acquired LRI in the US (Missouri) and in the Netherlands. Measurements included demographics, indicators of acute illness, general health condition, intake problems, and comorbid disease. Six-month mortality rates were calculated and Cox proportional hazards models were developed for mortality up to 2 years after diagnosis.<br />Results: Six-month mortality was 48.8% among Dutch residents and 36.4% among US residents. After multivariable adjustment, Dutch nationality was not associated with higher long-term mortality. Variables most strongly associated with long-term mortality were activity of daily living dependency and male gender. Other variables associated with outcome were diverse: respiratory difficulty, age, dehydration, congestive heart failure, decreased alertness, decubitus ulcers, Parkinson disease, weight loss/poor nutrition, and pulse rate.<br />Conclusion: LRI is followed by substantial mortality in the months after diagnosis, indicating high frailty of nursing home residents with dementia who develop LRI. A variety of patient characteristics, including many not directly related to LRI, were consistently associated with long-term mortality in two cohorts with differing illness severity. The results are relevant for informing families, evaluating poor long-term survival in the context of care and treatment, and balancing the potential burdens and benefits of care.
- Subjects :
- Aged, 80 and over
Anti-Bacterial Agents therapeutic use
Dementia classification
Female
Humans
Male
Netherlands
Prospective Studies
Respiratory Tract Infections complications
Respiratory Tract Infections physiopathology
Severity of Illness Index
United States
Dementia complications
Nursing Homes statistics & numerical data
Respiratory Tract Infections mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1538-9375
- Volume :
- 8
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of the American Medical Directors Association
- Publication Type :
- Academic Journal
- Accession number :
- 17619038
- Full Text :
- https://doi.org/10.1016/j.jamda.2007.03.005