Associations of Daily Walking Time With Pneumonia Mortality Among Elderly Individuals With or Without a Medical History of Myocardial Infarction or Stroke: Findings From the Japan Collaborative Cohort Study

Abstract

Background The association between daily walking and pneumonia mortality, stratified by the presence of disease conditions, such as myocardial infarction (MI) or stroke, was investigated. Methods The study participants were 22,280 Japanese individuals (9,067 men and 13,213 women) aged 65–79 years. Inverse propensity weighted competing risk model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for pneumonia mortality. Results After a median of 11.9 years of follow-up, 1,203 participants died of pneumonia. Participants who did not have a history of MI or stroke and who walked for 1 hour/day or more were less likely to die from pneumonia (HR 0.90; 95% CI, 0.82–0.98) than those walked for 0.5 hours/day. A similar inverse association of pneumonia and walking (0.5 hours/day) was observed among participants with a history of MI (HR 0.66; 95% CI, 0.48–0.90). Among the participants with a history of stroke, those who walked for 0.6–0.9 hours/day were less likely to die because of pneumonia (HR 0.65; 95% CI, 0.43–0.98). Conclusions Regular walking for ≥1 hour/day may reduce the risk of pneumonia mortality in elderly individuals with or without cardiovascular disease history.

Peripheral Immune Dysfunction: A Problem of Central Importance after Spinal Cord Injury

“…Part of the problem is that higher-level injuries result in loss of innervation to motor neurons that innervate the diaphragm and intercostal muscles, resulting in compromised respiratory motor control (reviewed in [ 18 ]). The lack of mobility in SCI persons also exacerbates this issue since exercise, like walking and running, has been shown to reduce pneumonia-related mortality [ 19 , 20 , 21 , 22 ]. However, what may make respiratory infections particularly deadly for SCI persons is that higher injuries above the level of thoracic segment 6 (T6) result in disruption of descending supraspinal input to sympathetic preganglionic neurons (SPNs) that innervate immune organs and modulate immune function, which we describe in more detail in a later section.…”

Association of Physical Activity and Lower Respiratory Tract Infection Outcomes in Patients With Cardiovascular Disease

“…Our study implies that the absolute benefit for older individuals with CVDs from engaging in physical activity would be much greater. Taken together with previous findings showing mortality benefits in older population, 13 health professionals should encourage older individuals with CVDs to engage in physical activity to improve outcomes from LoRI.…”

“…Previous studies on respiratory tract infection and physical activity are mostly for general population and mainly focused on upper respiratory tract infection with a benign clinical course. 11 , 12 , 13 , 14 , 15 , 16 , 17 Among the studies on LoRI, inconsistent data exist. 11 , 12 , 13 , 15 Specifically, it is not clear whether a low level of physical activity, performed less than the minimum amount suggested in the guidelines, 5 , 6 could lower the risk of LoRI.…”

“… 11 , 12 , 13 , 14 , 15 , 16 , 17 Among the studies on LoRI, inconsistent data exist. 11 , 12 , 13 , 15 Specifically, it is not clear whether a low level of physical activity, performed less than the minimum amount suggested in the guidelines, 5 , 6 could lower the risk of LoRI. Clarifying the dose‐response association between physical activity and LoRI would be helpful to guide patients with CVD about proper physical activity.…”

Impact of physical frailty on the clinical outcomes of older patients hospitalized for pneumonia

“…[2][3][4][5] Previous studies have shown that daily walking habit and early rehabilitation are associated with a decline in mortality rate among patients with pneumonia. 6,7 Identification of prognostic factors is important for future initiatives to reduce the readmission and mortality rates and target the resources for those at highest risk.…”