Patients with dementia at increased risk for flu mortality

Posted November 20th 2009

by DPS

An epidemiological study on pneumonia and influenza (P&I) in adults in the United States aged 65 and over, reports that patients with dementia are diagnosed with flu less frequently, have shorter hospital stays, and have a 50% higher rate of death than those without dementia.

The three-pronged study, which analyzed geographic and demographic patterns of P&I and the relationship between P&I and health care accessibility, was published online in advance of print in the Journal of the American Geriatrics Society.

“The increased mortality of older patients with dementia hospitalised for flu may be indicative of inadequacies in health care quality and accessibility. It could be beneficial to refine guidelines for the immunization, testing, and treatment of flu in older patients with dementia when planning for the possibility of a flu pandemic,” said first and senior author, Elena Naumova, Professor of public health and community medicine at Tufts University School of Medicine.

Dementia, defined by the authors as cognitive impairment to the extent that normal activity is impaired, causes unique obstacles to the early diagnosis and treatment of flu. Patients may have difficulty communicating symptoms and medical complications due to poor oral hygiene or impaired swallowing.

Additionally, the authors believe that limited access to health care services and inadequate testing practices may contribute to the higher rates of mortality and lower rates of diagnosis of flu seen in older patients with dementia.

A geographic analysis of the data showed that P&I rates were highest among older adults in poor and rural areas, where there is a lower concentration of health care facilities.

“Limited access to specialised health care services can delay diagnosis and treatment of the flu, causing it to progress to pneumonia, the fifth leading cause of death among the elderly. This study has helped us identify this vulnerable population, and now further study is needed to confirm the findings and assess the testing and vaccination policies for older patients with dementia,” said Professor Naumova.