Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection
Rieko Okada,1 Takashi Okada,2 Akira Okada,2 Hideyuki Muramoto,3 Masahisa Katsuno,4 Gen Sobue,4 Nobuyuki Hamajima11Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 2Okada Medical Clinic, 3Muramoto Clinic, 4Department of Neurology, Nagoya University Graduate School of...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2012-11-01
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| Series: | Clinical Interventions in Aging |
| Subjects: | |
| Online Access: | https://www.dovepress.com/severe-brain-atrophy-in-the-elderly-as-a-risk-factor-for-lower-respira-peer-reviewed-article-CIA |
| _version_ | 1818858101269331968 |
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| author | Okada R Okada T Okada A Muramoto H Katsuno M Sobue G Hamajima N |
| author_facet | Okada R Okada T Okada A Muramoto H Katsuno M Sobue G Hamajima N |
| author_sort | Okada R |
| collection | DOAJ |
| description | Rieko Okada,1 Takashi Okada,2 Akira Okada,2 Hideyuki Muramoto,3 Masahisa Katsuno,4 Gen Sobue,4 Nobuyuki Hamajima11Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 2Okada Medical Clinic, 3Muramoto Clinic, 4Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanBackground: The purpose of this study is to determine whether elderly subjects with severe brain atrophy, which is associated with neurodegeneration and difficulty swallowing (dysphagia), are more susceptible to lower respiratory tract infections (LRTI), including pneumonia.Methods: The severity of brain atrophy was assessed by computed tomography in 51 nursing home residents aged 60–96 years. The incidence of LRTI, defined by body temperature ≥ 38.0°C, presence of two or more respiratory symptoms, and use of antibiotics, was determined over 4 years. The incidence of LRTI was compared according to the severity and type of brain atrophy.Results: The incidence rate ratio of LRTI was significantly higher (odds ratio 4.60, 95% confidence interval 1.18–17.93, fully adjusted P = 0.028) and the time to the first episode of LRTI was significantly shorter (log-rank test, P = 0.019) in subjects with severe brain atrophy in any lobe. Frontal and parietal lobe atrophy was associated with a significantly increased risk of LRTI, while temporal lobe atrophy, ventricular dilatation, and diffuse white matter lesions did not influence the risk of LRTI.Conclusion: Elderly subjects with severe brain atrophy are more susceptible to LRTI, possibly as a result of neurodegeneration causing dysphagia and silent aspiration. Assessing the severity of brain atrophy might be useful to identify subjects at increased risk of respiratory infections in a prospective manner.Keywords: brain atrophy, dysphagia, elderly, pneumonia, respiratory infection, white matter lesions |
| first_indexed | 2024-12-19T08:50:56Z |
| format | Article |
| id | doaj.art-33c5a002659b457e988822cb6286375c |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-19T08:50:56Z |
| publishDate | 2012-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-33c5a002659b457e988822cb6286375c2022-12-21T20:28:44ZengDove Medical PressClinical Interventions in Aging1178-19982012-11-01Volume 748148711497Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infectionOkada ROkada TOkada AMuramoto HKatsuno MSobue GHamajima NRieko Okada,1 Takashi Okada,2 Akira Okada,2 Hideyuki Muramoto,3 Masahisa Katsuno,4 Gen Sobue,4 Nobuyuki Hamajima11Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 2Okada Medical Clinic, 3Muramoto Clinic, 4Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, JapanBackground: The purpose of this study is to determine whether elderly subjects with severe brain atrophy, which is associated with neurodegeneration and difficulty swallowing (dysphagia), are more susceptible to lower respiratory tract infections (LRTI), including pneumonia.Methods: The severity of brain atrophy was assessed by computed tomography in 51 nursing home residents aged 60–96 years. The incidence of LRTI, defined by body temperature ≥ 38.0°C, presence of two or more respiratory symptoms, and use of antibiotics, was determined over 4 years. The incidence of LRTI was compared according to the severity and type of brain atrophy.Results: The incidence rate ratio of LRTI was significantly higher (odds ratio 4.60, 95% confidence interval 1.18–17.93, fully adjusted P = 0.028) and the time to the first episode of LRTI was significantly shorter (log-rank test, P = 0.019) in subjects with severe brain atrophy in any lobe. Frontal and parietal lobe atrophy was associated with a significantly increased risk of LRTI, while temporal lobe atrophy, ventricular dilatation, and diffuse white matter lesions did not influence the risk of LRTI.Conclusion: Elderly subjects with severe brain atrophy are more susceptible to LRTI, possibly as a result of neurodegeneration causing dysphagia and silent aspiration. Assessing the severity of brain atrophy might be useful to identify subjects at increased risk of respiratory infections in a prospective manner.Keywords: brain atrophy, dysphagia, elderly, pneumonia, respiratory infection, white matter lesionshttps://www.dovepress.com/severe-brain-atrophy-in-the-elderly-as-a-risk-factor-for-lower-respira-peer-reviewed-article-CIAbrain atrophydysphagiaelderlypneumoniarespiratory infectionwhite matter lesions |
| spellingShingle | Okada R Okada T Okada A Muramoto H Katsuno M Sobue G Hamajima N Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection Clinical Interventions in Aging brain atrophy dysphagia elderly pneumonia respiratory infection white matter lesions |
| title | Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection |
| title_full | Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection |
| title_fullStr | Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection |
| title_full_unstemmed | Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection |
| title_short | Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection |
| title_sort | severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection |
| topic | brain atrophy dysphagia elderly pneumonia respiratory infection white matter lesions |
| url | https://www.dovepress.com/severe-brain-atrophy-in-the-elderly-as-a-risk-factor-for-lower-respira-peer-reviewed-article-CIA |
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