Modifiable Risk Factors for Pneumonia Requiring Hospitalization of Community-Dwelling Older Adults: The Health, Aging, and Body Composition Study
Article first published online: 17 JUN 2013
© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 61, Issue 7, pages 1111–1118, July 2013
How to Cite
J Am Geriatr Soc 61:1111-1118, 2013.
- Issue published online: 15 JUL 2013
- Article first published online: 17 JUN 2013
- National Institute on Aging (NIA). Grant Numbers: R01 AG030575, K07 AG030093, K23 AG028691, R01-AG028050
- Claude D. Pepper Center. Grant Numbers: P30 AG21342, N01-AG-6–2101, N01-AG-6–2103, N01-AG-6–2106
- National Institute of Nursing Research. Grant Number: R01-NR012459
- Clinical and Translational Science Award. Grant Number: UL1 RR024139
- National Center for Research Resources
- the Intramural Research Program of the National Institutes of Health
- risk factors
To identify novel modifiable risk factors, focusing on oral hygiene, for pneumonia requiring hospitalization of community-dwelling older adults.
Prospective observational cohort study.
Memphis, Tennessee, and Pittsburgh, Pennsylvania.
Of 3,075 well-functioning community-dwelling adults aged 70 to 79 enrolled in the Health, Aging, and Body Composition Study from 1997 to 1998, 1,441 had complete data in the data set of all variables used, a dental examination within 6 months of baseline, and were eligible for this study.
The primary outcome was pneumonia requiring hospitalization through 2008.
Of 1,441 participants, 193 were hospitalized for pneumonia. In a multivariable model, male sex (hazard ratio (HR) = 2.07, 95% confidence interval (CI) = 1.51–2.83), white race (HR = 1.44, 95% CI = 1.03–2.01), history of pneumonia (HR = 3.09, 95% CI = 1.86–5.14), pack-years of smoking (HR = 1.006, 95% CI = 1.001–1.011), and percentage of predicted forced expiratory volume in 1 minute (moderate vs mild lung disease or normal lung function, HR = 1.78, 95% CI = 1.28–2.48; severe lung disease vs mild lung disease or normal lung function, HR = 2.90, 95% CI = 1.51–5.57) were nonmodifiable risk factors for pneumonia. Incident mobility limitation (HR = 1.77, 95% CI = 1.32–2.38) and higher mean oral plaque score (HR = 1.29, 95% CI = 1.02–1.64) were modifiable risk factors for pneumonia. Average attributable fractions revealed that 11.5% of cases of pneumonia were attributed to incident mobility limitation and 10.3% to a mean oral plaque score of 1 or greater.
Incident mobility limitation and higher mean oral plaque score were two modifiable risk factors that 22% of pneumonia requiring hospitalization could be attributed to. These data suggest innovative opportunities for pneumonia prevention among community-dwelling older adults.