DISABILITY AND COGNITIVE IMPAIRMENT ARE RISK-FACTORS FOR PNEUMONIA-RELATED MORTALITY IN OLDER ADULTS

The role of functional and cognitive limitations in the risk of pneumo nia-related mortality in older adults was examined. As part of a cohor t study in 3 communities (East Boston, MA; New Haven, CT; and Iowa and Washington Counties, IA), 6,234 women and 4,035 men ages 65 or older completed baseline interviews between 1981 an 1983 and were followed f or up to 6 years. Sex-specific Cox proportional-hazards regression mod els were used to examine the association of baseline physical and cogn itive functioning with report pneumonia (ICD9 480-486) as an underlyin g, immediate, or contributing cause of death. During followup, a total of 243 men and 160 women died with pneumonia. Adjusting for age, race , education, evidence of five chronic diseases, and smoking status, a significantly increased risk of pneumonia mortality (P < 0.05) was fou nd for limitations in activities of daily living and cognitive impairm ent among both men and women. Inability to walk a half mile, climb sta irs, or perform heavy housework was significantly associated with incr eased risk of pneumonia mortality for women but not for men in the sam e multivariate models. Men and women whose body-mass index was above t he median had significantly lower risk of pneumonia mortality compared with those in the lowest quartile. Further elucidation of the sequenc e between physical and cognitive impairment and risk of pneumonia will be important in reducing pneumonia-associated morbidity and mortality .