Junsong Xu, Ran Meng, Jie Yan, Wei Zheng, Yuquan Wu, Qingyong Chen
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引用次数: 0
Abstract
Aim: Dementia and aspiration pneumonia are common and debilitating conditions in older adults. While both are significant contributors to morbidity and mortality, the interaction between these conditions remains inadequately understood. This study aimed to explore the bidirectional relationship between dementia and aspiration pneumonia and to assess its impact on cognitive decline in older patients.
Methods: A retrospective cohort analysis of 500 elderly dementia patients at a tertiary care center (2018--2022) was conducted, and participants were classified by aspiration pneumonia occurrence. Cognitive function was assessed via the Mini-Mental State Examination (MMSE) at baseline and follow-up, with Kaplan-Meier analysis evaluating time-to-pneumonia and Cox regression modeling of bidirectional relationships while adjusting for confounders.
Results: Among 500 dementia patients (mean age 78.3 ± 7.2 years), Kaplan-Meier analysis revealed significantly earlier pneumonia onset in severe dementia patients (log-rank P < 0.001), with Cox regression showing that severe dementia conferred triple the pneumonia risk (hazard ratio [HR] = 3.01, 95% confidence interval [CI]: 2.15-4.21) and that swallowing dysfunction independently increased the hazard ratio 3.45-fold (95% CI: 2.61-4.55); aspiration pneumonia accelerated cognitive decline (β = -2.35, 95% CI: -3.12 to -1.58).
Conclusion: This study revealed that dementia severity substantially increases time-dependent pneumonia hazard (severe dementia HR = 3.01), while pneumonia accelerates cognitive deterioration, forming a bidirectional cycle amplified by swallowing dysfunction. Early dysphagia management and pneumonia prevention strategies are crucial for disrupting this progression in older adults. Geriatr Gerontol Int 2025; ••: ••-••.
期刊介绍:
Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.