Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 65, Solna, Sweden.
BMC Infect Dis. 2024 Nov 1;24(1):1227. doi: 10.1186/s12879-024-10131-7.
Lower respiratory tract infections (LRTIs) are a major global health concern, particularly among older adults, who have an increased risk of poorer health outcomes that persist beyond the acute infectious episode. We aimed to investigate the mid-term (up to 7 years) and long-term (up to 12 years) effects of LRTIs on the objective health status trajectories of older adults, while also considering potential sex differences.
Cohort data of adults aged ≥ 60 years from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K) collected between 2001 and 2016 was analyzed. Information on LRTIs was obtained from the Swedish National Patient Register, and objective health status was assessed using the Health Assessment Tool (HAT) which incorporates indicators of mild and severe disability, cognitive and physical functioning, and multimorbidity. The LRTI-exposed and -unexposed participants were matched using propensity score matching based on an expansive list of potential confounders. Mixed linear models were used to analyze the association between LRTIs and changes in HAT scores.
The study included 2796 participants, 567 of whom were diagnosed with a LRTI. LRTIs were independently associated with an excess annual decline of 0.060 (95% CI: -0.107, -0.013) in the HAT score over a 7-year period. The associations were stronger among males, who experienced an excess annual decline of 0.108 (95% CI: -0.177, -0.039) in up to 7-years follow-up, and 0.097 (95% CI: -0.173, -0.021) in up to 12-years follow-up. The associations were not statistically significant among females in either follow-up period.
LRTIs, even years after the acute infectious period, seem to have a prolonged negative effect on the health of older adults, particularly among males. Preventative public health measures aimed at decreasing LRTI cases among older adults could help in preserving good health and functioning in old age.
下呼吸道感染（LRTIs）是一个重大的全球健康问题，特别是在老年人中，他们的健康状况较差，且持续时间超过急性感染期。我们旨在研究 LRTIs 对老年人体征健康状况轨迹的中期（最长 7 年）和长期（最长 12 年）影响，同时考虑潜在的性别差异。
分析了 2001 年至 2016 年期间瑞典 Kungsholmen 老龄化和护理国家研究（SNAC-K）中年龄≥60 岁的成年人队列数据。LRTI 信息来自瑞典国家患者登记处，客观健康状况采用健康评估工具（HAT）进行评估，该工具包含轻度和重度残疾、认知和身体功能以及多种合并症的指标。根据广泛的潜在混杂因素清单，通过倾向评分匹配对 LRTI 暴露和未暴露参与者进行匹配。使用混合线性模型分析 LRTIs 与 HAT 评分变化之间的关联。
这项研究共纳入了 2796 名参与者，其中 567 人被诊断为 LRTI。LRTIs 与 HAT 评分每年下降 0.060（95%CI：-0.107，-0.013）独立相关，在 7 年期间内。这些关联在男性中更强，他们在长达 7 年的随访中经历了每年 0.108（95%CI：-0.177，-0.039）的额外下降，在长达 12 年的随访中则经历了每年 0.097（95%CI：-0.173，-0.021）的额外下降。在任何随访期内，女性之间的关联均无统计学意义。
即使在急性感染期过后多年，LRTIs 似乎对老年人的健康仍有持续的负面影响，尤其是在男性中。旨在减少老年人 LRTI 病例的预防性公共卫生措施可能有助于保持老年人的良好健康和功能。
