A Systematic Review and Meta-Analysis Examining Pneumonia-Associated Mortality in Dementia

• Published in: Dementia and geriatric cognitive disorders Vol. 39; no. 1-2; pp. 52 - 67
• Main Authors: Foley, Norine C., Affoo, Rebecca H., Martin, Ruth E.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2015
• Subjects: Alzheimer Disease - complications; Bacterial pneumonia; Cause of Death; Complications and side effects; Dementia; Diagnosis; Humans; Patient outcomes; Pneumonia; Pneumonia - complications; Pneumonia - mortality; Review Article; Risk Factors; Systematic review; Canada; Alzheimer's disease; Cause of death; Epidemiology
• ISSN: 1420-8008; 1421-9824; 1421-9824
• DOI: 10.1159/000367783

Background: Although it is generally accepted that deaths associated with pneumonia are more common in patients with dementia, no comprehensive reviews on the subject have previously been published. Summary: Relevant studies were identified through a literature search of the PubMed, EMBASE, Scopus, and ISI Web of Science databases for publications up to August 2013. Studies were included if (1) a group of adult subjects with dementia and a (comparison) group composed of subjects without dementia were included, (2) the cause(s) of death was/were reported, and (3) pneumonia was identified as one of the possible causes of death. The occurrence of death due to pneumonia associated with dementia was expressed as an odds ratio (OR) with 95% confidence interval (CI). Thirteen studies were included. The odds of death resulting from pneumonia were significantly increased for persons with any form of dementia compared with those without dementia (OR = 2.22, 95% CI 1.44-3.42, p < 0.001). In a subgroup analysis, using the results from 8 studies that restricted inclusion to persons with Alzheimer's disease, the odds of death resulting from pneumonia were also significantly higher (OR = 1.70, 95% CI 1.12-2.58, p = 0.013). Key Messages: The odds of pneumonia-associated mortality were increased more than 2-fold for patients with dementia. © 2014 S. Karger AG, Basel