scholarly journals Hospitalized community-acquired pneumonia in the elderly: an Australian case-cohort study

2008 ◽  
Vol 137 (2) ◽  
pp. 194-202 ◽  
Author(s):  
S. A. SKULL ◽  
R. M. ANDREWS ◽  
G. B. BYRNES ◽  
D. A. CAMPBELL ◽  
H. A. KELLY ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Ad Hoc ◽  
Patient Characteristics ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Hospital Discharges ◽  
Tertiary Hospitals ◽  
Australian Community ◽  
Icd 10 ◽  
Australian Case

SUMMARYThis study describes the epidemiology of community-acquired pneumonia (CAP) in elderly Australians for the first time. Using a case-cohort design, cases with CAP were in-patients aged ⩾65 years with ICD-10-AM codes J10-J18 admitted over 2 years to two tertiary hospitals. The cohort sample was randomly selected from all hospital discharges, frequency-matched to cases by month. Logistic regression was used to estimate risk ratios for factors predicting CAP or associated mortality. A total of 4772 in-patients were studied. There were 1952 cases with CAP that represented 4% of all elderly admissions: mean length of stay was 9·0 days and 30-day mortality was 18%. Excluding chest radiograph, 520/1864 (28%) cases had no investigations performed. The strongest predictors of CAP were previous pneumonia, history of other respiratory disease, and aspiration. Intensive-care-unit admission, renal disease and increasing age were the strongest predictors of mortality, while influenza vaccination conferred protection. Hospitalization with CAP in the elderly is common, frequently fatal and a considerable burden to the Australian community. Investigation isad hocand management empirical. Influenza vaccination is associated with reduced mortality. Patient characteristics can predict risk of CAP and subsequent mortality.

Influenza vaccination in the elderly

1999 ◽  
Vol 55 (22) ◽  
pp. 1591-1593
Author(s):  
SNACKEN R
Keyword(s):  
Influenza Vaccination ◽  
The Elderly

scholarly journals Daily Stimulation and Cognitive Functioning: The Importance of the Participation of Healthy Older People in Cognitively Demanding Everyday Activities

2014 ◽  
Vol 4 (3) ◽  
pp. 309-319
Author(s):  
José Antonio Labra Pérez ◽  
Julio Menor
Keyword(s):  
Cognitive Functioning ◽  
Urban Areas ◽  
Ad Hoc ◽  
The Elderly ◽  
Protective Mechanism ◽  
Everyday Activity ◽  
Neuropsychological Measures ◽  
Rural And Urban Areas ◽  
Everyday Activities ◽  
Rural And Urban

The participation of the elderly in cognitively demanding activities is considered an enhancing factor of cognitive function. However, the life cycle psychosocial variables such as education and type of profession also influence in cognitive functioning. The objective of this study is to analyze the relationship between daily stimulation and cognitive functioning in a sample of healthy older adults, controlling the effects of education and the type of profession. The study involved 164 adults over 60 years, from rural and urban areas, with different levels of education and professional level which were assessed with an extensive battery of neuropsychological measures, as well as in an inventory of everyday activities built ad hoc. The results show that different cognitively demanding everyday activities are related to with cognitive processes, both fluids and crystallized. Furthermore, it was found that daily stimulation plays an important role in cognitive functioning outside of education and the type of profession performed. Overall, the results of this study shows the importance of everyday activity as a protective mechanism against cognitive decline, as well as the need to adopt a model of active aging

scholarly journals 10. Kinetics of Post-Vaccination Seroprotection to S. Pneumonia for the Immune-Compromised and Vaccine-Naïve Populations

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S27-S28
Author(s):  
Jeffrey Gruenglas ◽  
James Mond ◽  
Micaela Scobie ◽  
Cynthia Tolman ◽  
Joseph Martinez
Keyword(s):  
Capsular Polysaccharide ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Prior History ◽  
Antibody Activity ◽  
Vaccine Response ◽  
Serum Samples ◽  
Opsonic Activity ◽  
And Control

Abstract Background S. pneumonia infection presents a significant challenge, accounting for 20–38% of hospital-acquired pneumonia, and the leading cause of community-acquired pneumonia despite availability of effective vaccines. Incidence is highest in children under 2 years, the immunocompromised, and elderly. CDC has reported the emergence of antibiotic resistance in ~30% of cases, adding to risk of morbidity and mortality. Fewer than half of the elderly are vaccinated and vulnerable to infection on admission. Passive immunotherapy as an adjunct to vaccines may improve outcomes in such populations. The objective of this study was to evaluate whether seroprotective response induced with a pneumococcal conjugate vaccine could rapidly yield protective opsonic levels of antibody within anticipated duration of hospitalization. Methods Healthy donors (n=30) were immunized with Prevnar. Blood was drawn on days 0, 3, 7, 10, 14, 21, and 28. Samples were pooled and tested for presence of functional opsonic antibodies recognizing capsular polysaccharides. Clearance mechanism of S. pneumonia was based on antibody recognition to pneumococcal capsular polysaccharide and opsonic titers used as an in vitro surrogate to evaluate the efficacy of vaccine. Results There was little to no opsonic activity against most serotypes on day 0, except for low antibody activity with serotypes 1, 3, 4, and 5. Titers increased, with protective levels achieved by day 10 for most serotypes (except 14 and 18C), peaking at day 14 or after across serotypes (Figures 1 and 2). Average titers rose from log2 titer 2 on day 0 to log2 titer 8 on days 21 and 28. Titers against most serotypes reached log2 10 (titer 1024) or higher. Patients remained susceptible to nosocomial infection for at least 10 days post admission until protective titers are reached. OPK titers (log2 scale) for serum samples on day 0 (pre), day 3, 7, 10, 14, 21, 28, and control for S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V. N=2. OPK titers (log2 scale) for serum samples on day 0 (pre), day 3, 7, 10, 14, 21, 28, and control for S. pneumoniae serotypes 14, 18C, 19A, 19F, and 23F. N=2. Conclusion Patients with no prior history of vaccination (or inability to mount response) with Prevnar or pneumovax remain vulnerable to S. pneumonia infection even if vaccinated on entry, due to delayed kinetics in reaching protective titers. These patients may require prophylactic intervention of hyperimmune Ig with high opsonic titers to S. pneumonia, providing protection until vaccine response elicits protective antibodies. Disclosures All Authors: No reported disclosures

scholarly journals Influenza Vaccination Campaign during the COVID-19 Pandemic: The Experience of a Research and Teaching Hospital in Milan

2021 ◽  
Vol 18 (11) ◽  
pp. 5874
Author(s):  
Pier Mario Perrone ◽  
Giacomo Biganzoli ◽  
Maurizio Lecce ◽  
Emanuela Maria Campagnoli ◽  
Ambra Castrofino ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Teaching Hospital ◽  
Vaccination Coverage ◽  
Ad Hoc ◽  
Vaccination Campaign ◽  
Personal Data ◽  
Prevalence Ratio ◽  
Coverage Rate ◽  
Vaccination Coverage Rate ◽  
Research And Teaching

Background: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of this study is to analyze the 2020 influenza vaccination campaign, comparing it with the previous year’s in a research and teaching hospital in Northern Italy. Methods: adopting an approach based on combined strategies, three interventions were deployed: a promotional and educational campaign, vaccination delivery through both ad hoc and on-site ambulatories, and a gaming strategy. Personal data and professional categories were collected and analyzed using univariate logistic regression. Vaccinated HCWs were asked to fill in a questionnaire to describe their reasons for vaccination adherence. Results: the vaccination coverage rate (VCR) was 43.1%, compared to 21.5% in 2019. The highest increase was registered among administrative staff (308.3%), while physicians represent the most vaccinated category (n = 600). Moreover, residents (prevalence ratio (PR): 1.12; 95% CI 1.04–1.20), as well as intensive care (PR: 1.44; 95% CI: 1.24–1.69) and newborn workers (PR: 1.41; 95% CI: 1.20–1.65) were, respectively, the categories most frequently vaccinated for the first time. Conclusion: the significant increase in vaccination coverage rate confirms the suitability of the combined strategy of delivering the flu vaccination campaign and represents a first step towards reaching WHO recommended vaccination rates.

scholarly journals A probiotic fermented dairy product improves immune response to influenza vaccination in the elderly

2008 ◽  
Vol 67 (OCE5) ◽  
Author(s):  
J. Aubin ◽  
M. Remigy ◽  
L. Verseil ◽  
R. Bourdet-Sicard ◽  
S. Vaudaine ◽  
...  
Keyword(s):  
Immune Response ◽  
Influenza Vaccination ◽  
Dairy Product ◽  
The Elderly ◽  
Fermented Dairy Product ◽  
Fermented Dairy

scholarly journals Combined instruments for the screening of dementia in older people with low Education

2009 ◽  
Vol 67 (2a) ◽  
pp. 185-190 ◽  
Author(s):  
Cássio M.C. Bottino ◽  
Sonia E. Zevallos-Bustamante ◽  
Marcos A. Lopes ◽  
Dionisio Azevedo ◽  
Sérgio R. Hototian ◽  
...  
Keyword(s):  
Older People ◽  
The Elderly ◽  
Cognitive Tests ◽  
Weighted Sum ◽  
Dementia Screening ◽  
Moderate Dementia ◽  
Icd 10 ◽  
Roc Area ◽  
Low Educated ◽  
State Examination

OBJECTIVE: To determine which combination of cognitive tests and informant reports can improve the diagnostic accuracy of dementia screening in low educated older people. METHOD: Patients with mild to moderate dementia (n=34) according to ICD-10 and DSM-III-R criteria and 59 older controls were assessed with the Mini-Mental State Examination (MMSE) and the Fuld Object Memory Evaluation (FOME). Informants were assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the Bayer-Activities of Daily Living Scale. RESULTS: The 4 instruments combined with the mixed rule correctly classified 100% and the logistic regression (weighted sum) classified 95.7% of subjects. The weighted sum had a significantly larger ROC area compared to MMSE (p=0.008) and FOME (p=0.023). The specificity of the tested combinations was superior to the MMSE alone (p=0.002). CONCLUSIONS: Cognitive tests combined with informant reports can improve the screening of mild to moderate dementia in low educated older people.

The course of depression in the elderly: a longitudinal community-based study in Australia

1997 ◽  
Vol 27 (1) ◽  
pp. 119-129 ◽  
Author(s):  
A. S. HENDERSON ◽  
A. E. KORTEN ◽  
P. A. JACOMB ◽  
A. J. MACKINNON ◽  
A. F. JORM ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Service Use ◽  
Community Sample ◽  
The Elderly ◽  
Activity Levels ◽  
Sample Attrition ◽  
Poor Social Support ◽  
Icd 10 ◽  
Depressive States

Background. We report the outcome of depressive states after 3-4 years in a community sample of the elderly.Methods. A sample of 1045 persons aged 70+ years in 1990–1 was re-interviewed after 3·6 years.Results. Mortality (21·7%) and refusal or non-availability (10·4%) were higher in those who initially had had a diagnosis or symptoms of depression. Of those with an ICD-10 depressive episode in 1990–1, 13% retained that diagnosis. Of those who were not depressed initially only 2·5% had become cases. Depression was unrelated to age or apolipoprotein E genotype. The best predictors of the number of depressive symptoms at follow-up was the number at Wave 1, followed by deterioration in health and in activities of daily living, high neuroticism, poor current health, poor social support, low current activity levels and high service use. Depressive symptoms at Wave 1 did not predict subsequent cognitive decline or dementia.Conclusions. Non-random sample attrition is unavoidable. ICD-10 criteria yield more cases than other systems, while continuous measures of symptoms confer analytical advantages. Risk factors for depressive states in the elderly have been further identified. The prognosis for these states is favourable. At the community level, depressive symptoms do not seem to predict cognitive decline, as they do in referred series.

scholarly journals Mortality due to respiratory diseases in the elderly after influenza vaccination campaigns in the Federal District, Brazil, 1996-2009

2013 ◽  
Vol 39 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Francisca Magalhães Scoralick ◽  
Luciana Paganini Piazzolla ◽  
Liana Laura Pires ◽  
Cleudsom Neri ◽  
Wladimir Kummer de Paula
Keyword(s):  
Mortality Rate ◽  
Influenza Vaccination ◽  
Respiratory Diseases ◽  
Positive Impact ◽  
Vaccination Campaign ◽  
Age Groups ◽  
Federal District ◽  
The Elderly ◽  
Analysis Data ◽  
Proportional Mortality

OBJECTIVE: To compare mortality rates due to respiratory diseases among elderly individuals residing in the Federal District of Brasília, Brazil, prior to and after the implementation of a national influenza vaccination campaign. METHODS: This was an ecological time series analysis. Data regarding the population of individuals who were over 60 years of age between 1996 and 2009 were obtained from official databases. The variables of interest were the crude mortality rate (CMR), the mortality rate due to the respiratory disease (MRRD), and the proportional mortality ratio (PMR) for respiratory diseases. We performed a qualitative analysis of the data for the period prior to and after the implementation of the vaccination campaign (1996-1999 and 2000-2009, respectively). RESULTS: The CMR increased with advancing age. Over the course of the study period, we observed reductions in the CMR in all of the age brackets studied, particularly among those aged 80 years or older. Reductions in the MRRD were also found in all of the age groups, especially in those aged 80 years or older. In addition, there was a decrease in the PMR for respiratory diseases in all age groups throughout the study period. The most pronounced decrease in the PMR for respiratory diseases in the ≥ 70 year age bracket occurred in 2000 (immediately following the implementation of the national vaccination campaign); in 2001, that rate increased in all age groups, despite the greater adherence to the vaccination campaign in comparison with that recorded for 2000. CONCLUSIONS: Influenza vaccination appears to have a positive impact on the prevention of mortality due to respiratory diseases, particularly in the population aged 70 or over.

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