Frailty and the risk of infection-related hospitalizations in older age: Differences by sex.

Autor: Trevisan C; Geriatric Unit, Department of Medicine, University of Padova, via Giustiniani 2, 35128 Padova, Italy; Department of Medical Science, University of Ferrara, via Aldo Moro 2, 44124 Ferrara, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 17177 Stockholm, Sweden. Electronic address: caterina.trevisan.5@studenti.unipd.it., Noale M; Neuroscience Institute, National Research Council, via Giustiniani 2, 35128 Padova, Italy. Electronic address: marianna.noale@in.cnr.it., Amidei CB; Epidemiological Department (SER), Azienda Zero, via Avanzo 35, 35132 Padova, Italy., Ferroni E; Epidemiological Department (SER), Azienda Zero, via Avanzo 35, 35132 Padova, Italy. Electronic address: eliana.ferroni@azero.veneto.it., Basso C; Epidemiological Department (SER), Azienda Zero, via Avanzo 35, 35132 Padova, Italy. Electronic address: cristina.basso@azero.veneto.it., Fedeli U; Epidemiological Department (SER), Azienda Zero, via Avanzo 35, 35132 Padova, Italy. Electronic address: ugo.fedeli@azero.veneto.it., Baggio G; Italian Center for the Studies on Gender Health and Medicine, via Giustiniani 2, 35128 Padova, Italy. Electronic address: giovannella.baggio@unipd.it., Maggi S; Neuroscience Institute, National Research Council, via Giustiniani 2, 35128 Padova, Italy. Electronic address: stefania.maggi@in.cnr.it., Sergi G; Geriatric Unit, Department of Medicine, University of Padova, via Giustiniani 2, 35128 Padova, Italy. Electronic address: giuseppe.sergi@unipd.it.
Jazyk: angličtina
Zdroj: Maturitas [Maturitas] 2023 Feb; Vol. 168, pp. 1-6. Date of Electronic Publication: 2022 Nov 04.
DOI: 10.1016/j.maturitas.2022.10.009
Abstrakt: Objectives: To investigate the extent to which frailty is associated with infection-related hospitalizations in older men and women, and to explore whether, among women, previous exposure to endogenous estrogens in terms of age at menopause and number of pregnancies modify such a relationship.
Study Design: The sample comprised 2784 participants in the Progetto Veneto Anziani aged ≥65 years. At baseline and after 4.4 years, frailty was identified according to the presence of three or more of the following: weakness, exhaustion, weight loss, low physical activity, and low walking speed. A passive follow-up on infection-related hospitalizations and mortality was performed for 10 years of observation through linkage with regional registers.
Main Outcome Measures: The association between frailty and infection-related hospitalizations was assessed through mixed-effects Cox regressions.
Results: Frailty was significantly associated with a 78 % higher risk of infection-related hospitalization, with stronger results in men (hazard ratio = 2.32, 95 % confidence interval 1.63-3.30) than in women (hazard ratio = 1.54, 95 % confidence interval 1.18-2.02). Focusing on women, we found a possible modifying effect for the number of pregnancies but not menopausal age. Women who had experienced one or no pregnancy demonstrated a higher hazard of infection-related hospitalization as a function of frailty (hazard ratio = 3.00, 95 % confidence interval 1.58-5.71) than women who had experienced two or more pregnancies (hazard ratio = 1.68, 95 % confidence interval 1.18-2.39).
Conclusion: Frailty in older age increases the risk of infection-related hospitalizations, especially in men. The "immunologic advantage" of the female sex in younger age seems to persist also after menopause as a function of the number of pregnancies a woman has experienced.
Competing Interests: Declaration of competing interest The authors declare that they have no competing interest.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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