| Autor: |
Beach TG; Banner Sun Health Research Institute, Sun City, AZ., Russell A; Banner Sun Health Research Institute, Sun City, AZ., Sue LI; Banner Sun Health Research Institute, Sun City, AZ., Intorcia AJ; Banner Sun Health Research Institute, Sun City, AZ., Glass MJ; Banner Sun Health Research Institute, Sun City, AZ., Walker JE; Banner Sun Health Research Institute, Sun City, AZ., Arce R; Banner Sun Health Research Institute, Sun City, AZ., Nelson CM; Banner Sun Health Research Institute, Sun City, AZ., Hidalgo T; Banner Sun Health Research Institute, Sun City, AZ., Chiarolanza G; Banner Sun Health Research Institute, Sun City, AZ., Mariner M; Banner Sun Health Research Institute, Sun City, AZ., Scroggins A; Banner Sun Health Research Institute, Sun City, AZ., Pullen J; Banner Sun Health Research Institute, Sun City, AZ., Souders L; Banner Sun Health Research Institute, Sun City, AZ., Sivananthan K; Banner Sun Health Research Institute, Sun City, AZ., Carter N; Banner Sun Health Research Institute, Sun City, AZ., Saxon-LaBelle M; Banner Sun Health Research Institute, Sun City, AZ., Hoffman B; Banner Sun Health Research Institute, Sun City, AZ., Garcia A; Banner Sun Health Research Institute, Sun City, AZ., Callan M; Banner Sun Health Research Institute, Sun City, AZ., Fornwalt BE; Banner Sun Health Research Institute, Sun City, AZ., Carew J; Banner Sun Health Research Institute, Sun City, AZ., Filon J; Banner Sun Health Research Institute, Sun City, AZ., Cutler B; Banner Sun Health Research Institute, Sun City, AZ., Papa J; Banner Sun Health Research Institute, Sun City, AZ., Curry JR; Banner Sun Health Research Institute, Sun City, AZ., Oliver J; Banner Sun Health Research Institute, Sun City, AZ., Shprecher D; Banner Sun Health Research Institute, Sun City, AZ., Atri A; Banner Sun Health Research Institute, Sun City, AZ.; Brigham and Women's Hospital and Harvard Medical School, Boston, MA., Belden C; Banner Sun Health Research Institute, Sun City, AZ., Shill HA; Barrow Neurological Institute, Phoenix, AZ., Driver-Dunckley E; Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ., Mehta SH; Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ., Adler CH; Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ., Haarer CF; Pathology Specialists of Arizona, LLC., Ruhlen T; Pathology Specialists of Arizona, LLC., Torres M; Pathology Specialists of Arizona, LLC., Nguyen S; Pathology Specialists of Arizona, LLC., Schmitt D; Pathology Specialists of Arizona, LLC., Fietz M; Pathology Specialists of Arizona, LLC., Lue LF; Banner Sun Health Research Institute, Sun City, AZ., Walker DG; Shiga University Medical School, Shiga, Japan., Mizgerd JP; Pulmonary Center, Boston University School of Medicine, Boston, MA., Serrano GE; Banner Sun Health Research Institute, Sun City, AZ. |
| Abstrakt: |
There has been a markedly renewed interest in factors associated with pneumonia, a leading cause of death worldwide, due to its frequent concurrence with pandemics of influenza and Covid-19 disease. Reported predisposing factors to both bacterial pneumonia and pandemic viral lower respiratory infections are wintertime occurrence, older age, obesity, pre-existing cardiopulmonary conditions and diabetes. Also implicated are age-related neurodegenerative diseases that cause parkinsonism and dementia. We investigated the prevalence of autopsy-proven pneumonia in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), a longitudinal clinicopathological study, between the years 2006 and 2019 and before the beginning of the Covid-19 pandemic. Of 691 subjects dying at advanced ages (mean 83.4), pneumonia was diagnosed postmortem in 343 (49.6%). There were 185 subjects without dementia or parkinsonism while clinicopathological diagnoses for the other subjects included 319 with Alzheimer's disease dementia, 127 with idiopathic Parkinson's disease, 72 with dementia with Lewy bodies, 49 with progressive supranuclear palsy and 78 with vascular dementia. Subjects with one or more of these neurodegenerative diseases all had higher pneumonia rates, ranging between 50 and 61%, as compared to those without dementia or parkinsonism (40%). In multivariable logistic regression models, male sex and a non-summer death both had independent contributions (ORs of 1.67 and 1.53) towards the presence of pneumonia at autopsy while the absence of parkinsonism or dementia was a significant negative predictor of pneumonia (OR 0.54). Male sex, dementia and parkinsonism may also be risk factors for Covid-19 pneumonia. The apolipoprotein E4 allele, as well as obesity, chronic obstructive pulmonary disease, diabetes, hypertension, congestive heart failure, cardiomegaly and cigarette smoking history, were not significantly associated with pneumonia, in contradistinction to what has been reported for Covid-19 disease. |
