Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study

2020 ◽  
pp. 2002688
Author(s):  
Koos Korsten ◽  
Niels Adriaenssens ◽  
Samuel Coenen ◽  
Christopher Butler ◽  
Behnaz Ravanfar ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Respiratory Syncytial Virus ◽  
Severe Disease ◽  
Acute Respiratory Tract Infection ◽  
Community Dwelling ◽  
Symptom Duration ◽  
Care Approach ◽  
Syncytial Virus ◽  
Community Dwelling Older Adults

BackgroundRespiratory syncytial virus (RSV) infection in older adults is recognized as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years.MethodsThis international prospective observational cohort study is part of REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited before two independent RSV-seasons through general practitioner's offices. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV-season. . ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV-illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV-ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930).ResultsWe recruited 1040 participants (527 in season 2017–2018, 513 in season 2018–2019) with a median age of 75 years (range 60–100). 1023 (99%) lived independently at home at baseline. RSV-illness incidence was 4.2% (22/527) and 7.2% (37/513) in the respective seasons. RSV-illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalized or died from RSV-illness. In the 36 patients with PCR confirmed RSV-ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11/36 (31%) of cases. RSV-ARTI could not clinically be differentiated from all other ARTI based on symptoms.ConclusionThis European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care is often justified when RSV is suspected in family practice.

scholarly journals Antibody and Local Cytokine Response to Respiratory Syncytial Virus Infection in Community-Dwelling Older Adults

mSphere ◽  
2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Xiao Yu ◽  
Anke J. Lakerveld ◽  
Sandra Imholz ◽  
Marion Hendriks ◽  
Sofie C. A. ten Brink ◽  
...  
Keyword(s):  
Older Adults ◽  
Respiratory Syncytial Virus ◽  
Risk Groups ◽  
Community Dwelling ◽  
Severe Morbidity ◽  
Prevention And Treatment ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Community Dwelling Older Adults ◽  
Local Cytokine

ABSTRACT Respiratory syncytial virus (RSV) is increasingly recognized for causing severe morbidity and mortality in older adults, but there are few studies on the RSV-induced immune response in this population. Information on the immunological processes at play during RSV infection in specific risk groups is essential for the rational and targeted design of novel vaccines and therapeutics. Here, we assessed the antibody and local cytokine response to RSV infection in community-dwelling older adults (≥60 years of age). During three winters, serum and nasopharyngeal swab samples were collected from study participants during acute respiratory infection and recovery. RSV IgG enzyme-linked immunosorbent assays (ELISA) and virus neutralization assays were performed on serum samples from RSV-infected individuals (n = 41) and controls (n = 563 and n = 197, respectively). Nasal RSV IgA and cytokine concentrations were determined using multiplex immunoassays in a subset of participants. An in vitro model of differentiated primary bronchial epithelial cells was used to assess RSV-induced cytokine responses over time. A statistically significant increase in serum neutralization titers and IgG concentrations was observed in RSV-infected participants compared to controls. During acute RSV infection, a statistically significant local upregulation of beta interferon (IFN-β), IFN-λ1, IFN-γ, interleukin 1β (IL-1β), tumor necrosis factor alpha (TNF-α), IL-6, IL-10, CXCL8, and CXCL10 was found. IFN-β, IFN-λ1, CXCL8, and CXCL10 were also upregulated in the epithelial model upon RSV infection. In conclusion, this study provides novel insights into the basic immune response to RSV infection in an important and understudied risk population, providing leads for future studies that are essential for the prevention and treatment of severe RSV disease in older adults. IMPORTANCE Respiratory syncytial virus (RSV) can cause severe morbidity and mortality in certain risk groups, especially infants and older adults. Currently no (prophylactic) treatment is available, except for a partially effective yet highly expensive monoclonal antibody. RSV therefore remains a major public health concern. To allow targeted development of novel vaccines and therapeutics, it is of great importance to understand the immunological mechanisms that underlie (protection from) severe disease in specific risk populations. Since most RSV-related studies focus on infants, there are only very limited data available concerning the response to RSV in the elderly population. Therefore, in this study, RSV-induced antibody responses and local cytokine secretion were assessed in community-dwelling older adults. These data provide novel insights that will benefit ongoing efforts to design safe and effective prevention and treatment strategies for RSV in an understudied risk group.

scholarly journals Underlying cardiopulmonary conditions as a risk factor for influenza and respiratory syncytial virus infection among community-dwelling adults aged ≥65 years in Thailand: Findings from a two-year prospective cohort study

2021 ◽  
Author(s):  
Prabda Praphasiri ◽  
Manash Shrestha ◽  
Jayanton Patumanond ◽  
Sutthichai Nakphook ◽  
Sutthinan Chawalchitiporn ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Respiratory Syncytial Virus ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Respiratory Illness ◽  
Community Dwelling ◽  
Chronic Obstructive ◽  
Increased Risk ◽  
Syncytial Virus

Background: Adults with cardiopulmonary conditions are at increased risk for complications from influenza and respiratory syncytial virus (RSV) infection, but few data are available from middle-income countries. Methods: Using data from a prospective cohort study of influenza vaccine effectiveness among community-dwelling Thai adults aged ≥65 years, we estimated and compared the incidence of influenza and RSV in those with and without cardiopulmonary conditions. During May 2015-May 2017, older adults in a rural province in Thailand were followed weekly with year-round surveillance for acute respiratory illness (ARI), defined broadly as new onset or worsening of cough with or without fever, and hospitalized ARI. When ill, nasal self-swabs and/or nasopharyngeal swabs were collected for reverse-transcription polymerase chain reaction testing. We used Poisson regression to calculate incidence rate ratios (IRR), adjusting for age, sex, past healthcare-seeking behavior, weekly influenza activity, and influenza vaccination. Results: Overall, 3,220 adults with a median age of 71 years (IQR 68-76) were enrolled; 1,324 (41.1%) were male; and 313 (9.7%) had ≥1 underlying cardio-pulmonary condition, most commonly chronic obstructive pulmonary disease (131; 41.2%) or asthma (73; 23.3%). Compared to those without, participants with cardiopulmonary conditions had higher incidences of ARI, influenza, and RSV (Adjusted IRR: 1.83, 95% CI 1.63-2.05; 1.84, 95% CI 1.05-3.23; 2.02, 95% CI 1.10-3.72, respectively). Conclusion: Our findings show that older adults in rural Thailand with cardiopulmonary conditions have increased rates of ARI, influenza, and RSV infections, and support efforts to ensure this population has access to influenza vaccines and other respiratory illness prevention measures.

scholarly journals Functional Constipation and Anorexia in Community-Dwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS)

2021 ◽  
Vol 18 (11) ◽  
pp. 5754
Author(s):  
Eunjin Jeong ◽  
Jung A Kim ◽  
Byung Sung Kim ◽  
Chang Kyun Lee ◽  
Miji Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Depressed Mood ◽  
Mmse Score ◽  
Univariate Analysis ◽  
Functional Constipation ◽  
Community Dwelling ◽  
Geriatric Syndrome ◽  
Female Sex ◽  
Community Dwelling Older Adults

Anorexia is a relevant geriatric syndrome because it accounts for most malnutrition in older adults. Constipation has been suggested as a risk factor for anorexia. This study aimed to examine the association between anorexia and functional constipation in community-dwelling older adults. Data on 899 subjects aged 72–86 years were obtained from a follow-up survey of the Korean Frailty and Aging Cohort Study in 2018. Anorexia was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ), while functional constipation was diagnosed based on Rome IV criteria. Anorexia and functional constipation were present in 30.9% and 19.6% of the participants, respectively. Age, female sex, chewing problems, malnutrition, polypharmacy, low Mini-Mental Status Examination (MMSE) score, depressed mood, low serum albumin, and functional constipation were associated with anorexia in the univariate analysis. In the multivariate logistic regression, functional constipation was associated with anorexia (OR 1.478, 95% CI 1.038–2.104) after adjusting for age, female sex, and MMSE score. However, after further adjusting for depressed mood (OR 2.568) and chewing problems (OR 2.196), the relationship was no longer significant. This study showed that functional constipation is associated with anorexia in community-dwelling older adults, but this association is confounded by depressed mood and chewing problems.

Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Frailty Status ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

A 3-year prospective cohort study of dietary patterns and frailty risk among community-dwelling older adults

2021 ◽  
Vol 40 (1) ◽  
pp. 229-236 ◽  
Author(s):  
Chi Hsien Huang ◽  
Beatriz Arakawa Martins ◽  
Kiwako Okada ◽  
Eiji Matsushita ◽  
Chiharu Uno ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Dietary Patterns ◽  
Prospective Cohort ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals What influences diet quality in older people? A qualitative study among community-dwelling older adults from the Hertfordshire Cohort Study, UK

2017 ◽  
Vol 20 (15) ◽  
pp. 2685-2693 ◽  
Author(s):  
Ilse Bloom ◽  
Wendy Lawrence ◽  
Mary Barker ◽  
Janis Baird ◽  
Elaine Dennison ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Older People ◽  
Social Engagement ◽  
Community Dwelling ◽  
Related Factors ◽  
Age Related ◽  
Hertfordshire Cohort Study ◽  
The Uk ◽  
Community Dwelling Older Adults

AbstractObjectiveTo explore influences on diet in a group of community-dwelling older adults in the UK.DesignData were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.SettingHertfordshire, UK.SubjectsParticipants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.ResultsNinety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.ConclusionsInterventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.

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