Researchers have developed a “prediction score” to help healthcare professionals determine which older adults might be most at risk for developing pneumonia. The study detailing the score, “Predicting 2-Year Risk of Developing Pneumonia in Older Adults without Dementia,” was published in the Journal of American Geriatrics Society.
Community-acquired pneumonia (CAP) is an important cause of morbidity and mortality in older adults (ages 65 and over). In the United States, the incidence of CAP in this population is 20 to 30 cases per 1,000 person-years. Approximately 40 percent of older adults with CAP are hospitalized, with high rates of complications. Risk factors include advanced age, chronic lung disease, smoking, low body mass index (BMI), and functional status impairments.
To develop scores that could predict two-year risk of developing CAP in dementia-free older adults, the researchers turned to the Adult Changes in Thought (ACT) study, which enrolled 3,392 older adults living in the Seattle area between 1994–96 and 2000–03. Eligible participants lived in a community dwelling, were cognitively intact, and age 65 or older.
Potential risk factors for pneumonia were identified from questionnaire data, physical measures (grip strength and gait speed), and interviewer assessments, including medical history, functional status, smoking and alcohol use, cognitive function, personal care, and problem solving abilities. Administrative database information on comorbid illnesses, laboratory tests, and prescriptions dispensed was also assessed. The researchers defined incident CAP using patients medical records.
Participants (59% female) made 12,998 visits, at which risk factors were assessed. During the study, 642 pneumonia events were observed, and 574 patients died. The researchers determined the seven factors critical to a pneumonia prediction score included: age, sex, chronic obstructive pulmonary disease, congestive heart failure, body mass index, and use of inhaled or oral corticosteroids.
According to the researchers, the findings from this study can help clinicians use the pneumonia prediction score to encourage older adults to get the pneumococcal vaccine, as well as to counsel at-risk individuals about positive behavioral changes, such as quitting smoking.
“A risk score based on these seven variables, information on which is commonly available in electronic medical records (EMRs), had equal or better performance … than scores including more-detailed data such as functional status,” the researchers concluded.
