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Can Daily Walking Alone Reduce Pneumonia-Related Mortality among Older People?

ABSTRACT: Pneumonia-related mortality is expected to increase in aging societies. This prospective cohort study examined whether daily walking (1?hour/day) could reduce pneumonia-related mortality among older people who lacked other exercise habits. We analysed data from Japanese Specific Health Checkup across 82 municipalities in 7 prefectures among participants aged ?65 years who participated in daily walking but did not regularly engage in other forms of exercise (n?=?132,448). Information on walking habits and health-related indicators was assessed at a baseline survey conducted between 2008 and 2014. Pneumonia-related and all-cause mortality were followed for a median of 3.4 years. We performed a competing risk model with propensity score matching to evaluate the association between daily walking habits and pneumonia-related mortality. Our propensity-matched analysis revealed a significant association between daily walking and pneumonia-related mortality among older people who lacked other exercise habits, such that the sub-hazard ratio and 95% confidence intervals were 0.58 (0.39, 0.86). This study extends the findings of previous research on the effects of exercise on pneumonia by demonstrating that daily walking alone is sufficient to reduce pneumonia-related mortality among older people who do not regularly engage in other exercise habits.

SUBMITTER: Ikeda T

PROVIDER: S-EPMC7244731 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Can Daily Walking Alone Reduce Pneumonia-Related Mortality among Older People?

Ikeda Takaaki T Inoue Sumito S Konta Tsuneo T Murakami Masayasu M Fujimoto Shouichi S Iseki Kunitoshi K Moriyama Toshiki T Yamagata Kunihiro K Tsuruya Kazuhiko K Narita Ichiei I Kondo Masahide M Shibagaki Yugo Y Kasahara Masato M Asahi Koichi K Watanabe Tsuyoshi T

Scientific reports 20200522 1

Pneumonia-related mortality is expected to increase in aging societies. This prospective cohort study examined whether daily walking (1 hour/day) could reduce pneumonia-related mortality among older people who lacked other exercise habits. We analysed data from Japanese Specific Health Checkup across 82 municipalities in 7 prefectures among participants aged ≥65 years who participated in daily walking but did not regularly engage in other forms of exercise (n = 132,448). Information on walking h ...[more]

PMID: 32444618

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Project description:BackgroundAgeing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national nutritional supplementation program and/or a physical activity intervention among older people in Chile.Methods and findingsWe conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65-67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers) into the study and recruited 2,799 individuals in 2005 (~100 per cluster). The interventions were a daily micronutrient-rich nutritional supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrollment. Adherence was good for the nutritional supplement (~75%), and moderate for the physical activity intervention (~43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio?=?1.00; 95% confidence interval 0.61-1.63; p?=?0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9-53.8; p?=?0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention.ConclusionsChile's nutritional supplementation program for older people is not effective in reducing the incidence of pneumonia. This trial suggests that the provision of locally accessible physical activity classes in a transition economy population can be a cost-effective means of enhancing physical function in later life.Trial registrationCurrent Controlled Trials ISRCTN 48153354.

Project description:BackgroundOlder patients hospitalized with community-acquired pneumonia (CAP) are at high risk for short-term mortality. Activity of daily living (ADL) is associated with clinical outcomes in older patients. We aimed to investigate the prognostic value of ADL upon admission on the in-hospital mortality in older patients with CAP.MethodsWe conducted a retrospective cohort study involving patients aged ≥65 years admitted to Beijing Chao-Yang hospital due to CAP between June 2012 and June 2020. ADL evaluation upon admission was performed by Barthel Index (BI). Data from all patients were extracted from the electronic medical records.ResultsFour thousand eight hundred eighty patients were included, 131 patients (2.7%) died during their hospitalization. Median BI in the Deceased group was 45 (20-65), Deceased group had lower BI scores than Survivors group (p < 0.001). Low BI (< 60) was more frequent in patients who died in the hospital than in patients discharged alive (69.5% vs. 13%, p < 0.001). In-hospital mortality was higher among patients with worse ADL upon admission (BI< 60) compared to those BI≥60 (12.6% vs. 0.9%). The worse ADL upon admission (BI< 60) was associated with an increase in the risk of death during CAP hospitalization, worse ADL upon admission (BI< 60) showed an odds ratio (OR) for in-hospital mortality of 7.53 (95%CI: 2.77-20.48; P < 0.01). This association remained significant after adjustment for age, comorbid conditions, respiratory failure, pathogens and laboratory findings (OR, 3.74; 95%CI, 2.37-5.91; P < 0.01). Receiver operating characteristic (ROC) curve revealed that BI upon admission is a predictor related to in-hospital mortality in elderly patients, the area under the ROC curve of BI in predicting in-hospital mortality was 0.81 (with 95% confidence interval: 0.78-0.85). The predictive value of ADL upon admission was better than age in our study population.ConclusionActivity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia.

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Can Daily Walking Alone Reduce Pneumonia-Related Mortality among Older People?

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Can Daily Walking Alone Reduce Pneumonia-Related Mortality among Older People?

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