Clinically diagnosed infections predict disability in activities of daily living among the oldest-old in the general population: the Leiden 85-plus Study

Abstract

Background: ageing is frequently accompanied by a higher incidence of infections and an increase in disability in activities of daily living (ADL).Objective: this study examines whether clinical infections [urinary tract infections (UTI) and lower respiratory tract infections (LRTI)] predict an increase in ADL disability, stratified for the presence of ADL disability at baseline (age 86 years).Design: the Leiden 85-plus Study. A population-based prospective follow-up study.Setting: general population.Participants: a total of 154 men and 319 women aged 86 years.Methods: information on clinical infections was obtained from the medical records. ADL disability was determined at baseline and annually thereafter during 4 years of follow-up, using the 9 ADL items of the Groningen Activity Restriction Scale.Results: in 86-year-old participants with ADL disability, there were no differences in ADL increase between participants with and without an infection (−0.32 points extra per year; P = 0.230). However, participants without ADL disability at age 86 years (n = 194; 41%) had an accelerated increase in ADL disability of 1.07 point extra per year (P < 0.001). For UTIs, this was 1.25 points per year (P < 0.001) and for LRTIs 0.70 points per year (P = 0.041). In this group, an infection between age 85 and 86 years was associated with a higher risk to develop ADL disability from age 86 onwards [HR: 1.63 (95% CI: 1.04–2.55)].Conclusions: among the oldest-old in the general population, clinically diagnosed infections are predictive for the development of ADL disability in persons without ADL disability. No such association was found for persons with ADL disability.

Prevalence and factors associated with one-year mortality of infectious diseases among elderly emergency department patients in a middle-income country

“…Likewise, an Israeli study from 2011 found an increased rate of hospital admission among older patients to 14.2% and the most common disease was lower respiratory tract infection, accounting for 41%. A study in the Netherlands found the oldest-old populations (age ≥ 85 years) who were independent in activities of daily living (ADL) beacame less able in ADLs with a diagnosis of infectious disease [7]. One study in Canada which assessed the temporal trend of salmonella infection found the incidence of infection in seniors could increase by 16% by 2018 [8].…”

Spatial Learning Responses to Lipopolysaccharide in Adult and Aged Rats

“…In older adults, an immune challenge such as an infection can lead to impaired cognition (Bucks et al, 2008), delirium (Fong, Tulebaev, & Inouye, 2009), or neurodegenerative disease progression (Perry, Cunningham, & Holmes, 2007). Other changes in the elderly related to infection may include a decline in functional ability or an inability to return to their previous state of functioning related to self-care and independence (Bula, Ghilardi, Wietlisbach, Petignat, & Francioli, 2004;Caljouw et al, 2013;Gozalo, Pop-Vicas, Feng, Gravenstein, & Mor, 2012). Associations between infections and cognitive impairment in the elderly are an area of increased investigation.…”

Cost-effectiveness analysis of quadrivalent influenza vaccination in at-risk adults and the elderly: an updated analysis in the UK

“…Thus, the impact of excluding herd effect from the present study is likely to be small. Another limitation is that the study does not attempt to include any potential declines in health status that may occur after influenza infection, particularly in elderly individuals 53,54 . Limitations also remain in the availability of detailed data to populate the model by age and risk status, as previously noted 14 .…”

“…Thus, the two age groups covering children and adolescents in the earlier analysis were excluded from this one. The other seven age groups covered adults and elderly people (50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64), 65-69, 70-74, 75-79, 80-84, !85 years) 14 . The at-risk group was further sub-divided into people with clinical risk conditions and people living in residential care homes.…”