Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Am Med Dir Assoc. 2011 Jun;12(5):344-54. doi: 10.1016/j.jamda.2010.12.099. Epub 2011 Mar 21.

Risk factors for aspiration pneumonia in frail older people: a systematic literature review.

Author information

  • 1BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium/Nijmegen, The Netherlands.

Abstract

OBJECTIVE:

To systematically review the risks for aspiration pneumonia in frail older people and the contribution of bad oral health among the risk factors.

DESIGN:

Systematic literature review.

SETTING:

PubMed (Medline), Web of Science, Cochrane Library, EMBASE, and CINAHL were searched for eligible studies, published in English in the period January 2000 to April 2009.

PARTICIPANTS:

Frail older people.

MEASUREMENTS:

Only publications with regard to hospitalized, institutionalized, or frail home-dwelling people of 60 years and older were eligible. Two authors independently assessed the publications for their methodological quality. Unadjusted and adjusted odds ratios and their corresponding 95% confidence intervals for respective risk factors related to aspiration pneumonia were extracted. The results were evaluated according to the levels of evidence of the Oxford Centre for Evidence-based Medicine.

RESULTS:

A total of 21 publications fulfilled the quality criteria. Evidence level 2a (systematic review with homogeneity of cohort studies) was found for a positive relationship between aspiration pneumonia and age, male gender, lung diseases, dysphagia, and diabetes mellitus; 2b (individual cohort study) for severe dementia, angiotensin I-converting enzyme deletion/deletion genotype, and bad oral health; 3a (systematic review with homogeneity of case-control studies) for malnutrition; 3b (individual case-control study) for Parkinson's disease and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health among the risk factors seems limited.

CONCLUSION:

Thirteen significant risk factors were identified: age, male gender, lung diseases, dysphagia, diabetes mellitus, severe dementia, angiotensin I-converting enzyme deletion/deletion genotype, bad oral health, malnutrition, Parkinson's disease, and the use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. The contribution of bad oral health seems limited.

Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

PMID:
21450240
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk