ACUTE RESPIRATORY TRACT INFECTION IN THE ELDERLY

老年人急性呼吸道感染

• 批准号: 3726660
• 负责人: WILLIAM HALL
• 金额: --
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3726660
• 关键词: aging; behavior test; blood chemistry; communicable disease transmission; disease /disorder prevention /control; dyspneas; exercise; frail elderly; functional ability; health care cost /financing; health care service utilization; human old age (65+); human subject; human very old age (85+); immunization; longitudinal human study; nosocomial infection control; nosocomial infections; respiratory disorder diagnosis; respiratory function; respiratory infections; statistics /biometry; tissue /cell culture; viral vaccines

Acute respiratory tract infections (ARTI) are responsible for more disability than any other acute illnesses in the United States. In the under 65 year old population, ARTI in aggregate are the major causes of absenteeism from school and work, decreased activity, and bed disability. Despite the well described episodic impact on mortality attributable to acute respiratory illness in the institutionalized and hospital bound elderly, very little information is available on the potential impact of the more common ARTI on the functional state of the frail elderly who are still being maintained in the community usually by a complex social and health care network. If ARTI have at lease a comparable disabling effect as observed in the younger population, these illnesses may represent some of the most important undefined factors leading to a decline in functional state and loss of independence in the frail elderly. Moreover, compared to other established and more well studied sentinel events leading to functional decline, such as coronary artery disease, hip fracture, acute cerebrovascular ischemia, ARTI may encompass some of the factors most amenable to primary and secondary interventional strategies. We propose therefore to test two major hypotheses concerning the relationship of ARTI to changes in functional state in a community dwelling frail elderly population: 1. The incidence, responsible pathogens, and modes of transmission of ARTI in non-institutionalized frail elderly will have a predictable epidemiologic pattern which will correlate with the over-all community pattern of infection at all age levels. The impact of intergenerational programs, i.e. contiguous adult and child day care centers, will be evaluated. These illnesses will have at least a comparable impact on reduction of independence as observed in the younger population and will be causally linked to clinically significant decline in the functional state of frail elderly, often being the sentinel event leading to deconditioning and eventually institutionalization. In addition to leading to transient worsening of known areas of functional disability, ARTI will be associated with the transient development of new domains of functional dependence. 2. Given an understanding of these predictable community patterns of ARTI in non-institutionalized frail elderly, specific interventions will result in less deconditioning, functional decline, and expenditures for health care. These specific interventions are: 1. Preventive Deconditioning, 2. Infection control to prevent nosocomial infection, 3. Respiratory Viral Vaccines.

急性呼吸道感染（ARTI）负责更多 残疾人比美国其他任何急性疾病。 在 65岁以下的人口，ARTI的总体原因是 学校和工作的缺勤，活动减少以及床残疾。 尽管描述了对死亡率的情节影响有很好的影响 机构和医院急性呼吸道疾病 老年人，几乎没有关于潜在影响的信息很少 关于虚弱的老年人功能状态的更常见的Arti 通常，通常由一个复杂的社会和 卫生保健网络。 如果Arti租赁了可比的残疾效果 正如年轻人口所观察到的那样，这些疾病可能代表一些 最重要的不确定因素导致功能下降 脆弱的老年人的状态和独立丧失。 而且，与 其他已建立且经过良好研究的前哨事件，导致 功能下降，例如冠状动脉疾病，髋部骨折，急性 脑血管缺血，ARTI可能包括一些最大的因素 适合初级和继发性介入策略。 因此，我们建议检验两个关于 ARTI与社区住宅中功能状态变化的关系 脆弱的老年人口： 1。发病率，负责的病原体和传播方式 非机构化脆弱的老年人的Arti将具有可预测的 流行病学模式将与全体社区相关 各个年龄段的感染模式。 的影响 代际计划，即连续的成人和儿童日托 中心将进行评估。 这些疾病至少会有 对降低独立性的可比影响如在 年轻的人口，将与临床上有因果关系 脆弱的老年人的功能状态大幅下降，通常 作为前哨事件，导致了调节并最终 制度化。 除了导致瞬态恶化 在已知的功能残疾领域，ARTI将与 功能依赖的新领域的瞬态发展。 2。考虑到这些可预测的ARTI社区模式 在非机构化脆弱的老年人中，具体的干预措施将 导致较少的缺陷，功能下降和支出 用于医疗保健。 这些具体干预措施是：1。预防性 调节，2。感染控制以防止医院感染， 3。呼吸道病毒疫苗。