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) 是导致更多疾病的原因 在美国，残疾率高于任何其他急性疾病。 在 65 岁以下人口中，ARTI 是导致 缺课和缺勤、活动减少以及卧床不起。 尽管对死亡率的偶发性影响有充分的描述， 机构和医院范围内的急性呼吸道疾病 老年人，关于其潜在影响的信息很少 更常见的 ARTI 对体弱老年人的功能状态有影响 通常仍然由复杂的社会和社区维持在社区中 医疗保健网络。 如果 ARTI 至少具有类似的致残效果 正如在年轻人中观察到的那样，这些疾病可能代表了一些 导致功能下降的最重要的未定义因素 体弱老年人的状态和丧失独立性。 此外，相比 其他已确定且经过更深入研究的哨兵事件导致 功能衰退，如冠状动脉疾病、髋部骨折、急性 脑血管缺血，ARTI 可能包含一些最常见的因素 适合初级和次级干预策略。 因此，我们建议检验两个主要假设： ARTI 与社区住宅功能状态变化的关系 体弱老年人口： 1. 发病率、致病病原体和传播方式 对于非机构化的体弱老年人来说，ARTI 将具有可预测的效果 与整个社区相关的流行病学模式 所有年龄段的感染模式。 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。 这些疾病至少有 观察到的对独立性降低的类似影响 较年轻的人群，并且与临床有因果关系 体弱老年人的功能状态显着下降，通常 是导致功能失调的哨兵事件，并最终 制度化。 除了导致短暂恶化 对于已知的功能障碍区域，ARTI 将与 功能依赖性新领域的短暂发展。 2. 了解这些可预测的 ARTI 社区模式 对于非机构化的体弱老年人，具体干预措施将 减少身体状况不佳、功能衰退和支出 用于医疗保健。 这些具体干预措施是： 1. 预防性 去适应，2.感染控制以防止院内感染， 3.呼吸道病毒疫苗。