Wednesday, December 2, 2009
Older adults run a higher risk of developing pneumonia following infections like influenza than younger people. These complications are potentially deadly. And some research suggests that seniors with dementia are particularly vulnerable to these infections.
This seems to be the case because, among other things, seniors with dementia are more likely to have trouble telling caregivers and healthcare providers about their symptoms. As a result, they may not get needed care as quickly as possible. Older adults with dementia are also more likely than others to have additional medical problems that can contribute to complications from influenza and pneumonia. About one in seven Americans 71 years and older suffers from dementia.
Older adults who have dementia as well as influenza or pneumonia and live in rural or other areas where access to care is limited may run an even higher risk of complications from these infections. Among other things, people in such areas have to travel further to get healthcare, and this delays care.
New Research in the Journal of the American Geriatrics Society
To get a better sense of how dementia and access to healthcare affect seniors' risks of complications from flu and pneumonia, researchers recently studied the Medicare records of older adults hospitalized for the two diseases between 1998 and 2002. All told, the researchers studied more than 6.25 million records.
The researchers found that seniors with dementia who were hospitalized with the flu had more severe conditions and worse outcomes than those without dementia. This could be because it took longer for these older adults to get treated or because their treatment was "less than adequate." The death rate for older patients who had dementia and were hospitalized with influenza was one and a half times the death rate for all seniors hospitalized with the flu. In addition, high hospitalization rates were 4.5 times more common in rural areas than in cities and other urban areas.
"Poor access to health care...and insufficient quality of health care" in these areas may result in "costly hospitalizations due to complications that can be avoided by preventive and appropriate care," the researchers write in the Journal of the American Geriatrics Society.
They conclude by saying that policy makers and health care administrators need to plan appropriate services for patients with dementia and make sure that they have better access to care and better outcomes.
What Should I Do?
Tell your healthcare provider immediately if you or an older loved one has symptoms of influenza: a high fever, chills, severe headache, muscle aches, chest pain and cough, ask for influenza testing; inquire information on safe and effective vaccination before the start of an influenza season.
The summary above is from the full report titled, "Pneumonia and Influenza Hospitalizations in Elderly with Dementia." It is in the December 2009 issue of the Journal of the American Geriatrics Society (Volume 57, Issue 12). The report is authored by Elena N. Naumova, PhD, Sara M. Parisi, MPH, Denise Castronovo, MS, Manisha Pandita, BA, Julia Wenger, MPH, and Paula Minihan, PhD.