Community-acquired pneumonia a problem for adults of all ages

Community-acquired pneumonia spells long-term health concerns for all adults, but simple practices can help prevent it, says public health researcher.

(Edmonton) It's often called "the old man's friend," but community-acquired pneumonia (CAP) is a major health concern for adults of all ages, according to new research from the University of Alberta.

Dean Eurich, associate professor in the U of A's School of Public Health, led a study showing serious, long-term health implications for adults diagnosed with CAP. The study was published in the American Journal of Respiratory and Critical Care Medicine.

Between 2000 and 2002, the researchers recruited more than 6,000 patients with CAP from six hospitals and seven emergency departments in Edmonton. The group was examined against nearly 30,000 other individuals who had never had pneumonia over a nine-year period.

Rates of mortality and morbidity were significantly higher in CAP patients than among those who had never had pneumonia during the study.

In fact, people in the study who had just one episode of CAP had an increased risk of death, as well as a greater likelihood of hospitalization, emergency department visits and CAP-related health-care encounters over the nine-year period.

A surprising finding was that young adults diagnosed with CAP had the worst relative outcomes of all patients. Although adults under age 25 are less likely to be infected in the first place, those who do get CAP have a twofold increase in risk of mortality compared with patients who had never had pneumonia.

"Our results suggest that CAP ought to be considered the young adult's adversary," says Eurich.

The good news, he explains, is that many episodes of CAP are preventable. "Our results suggest that we have likely underestimated the cost-effectiveness, impact and importance of the immunization to prevent pneumonia."

In addition to this, Eurich notes simple practices that promote good health can also be highly effective in preventing CAP infections, as well as reinfection.

"Pneumonia tends to get a foothold with individuals who are medically at risk due to other underlying health conditions, and in those in low-resource settings who are often unable to mount an effective immune response," says Eurich. "In addition to a person's underlying health status, a person's ability to fend off infection is also linked to their personal health habits, as well as support systems and a practical ability to prevent infection. The social determinants of health-such as income, social status, education and physical environment-are certainly in play here."

Practising good health habits, including healthy eating and regular exercise, is essential. This also includes avoiding smoking, washing your hands regularly and staying clear of people with respiratory infections, says Eurich.

In addition to this, Eurich encourages all those who are at risk to be vaccinated, including people with chronic disease or weakened immune systems, and those living in extended-care facilities.

"These results are very important from a public health perspective," explains Eurich. "In many cases, infections can be prevented, and the associated negative health risks can be avoided altogether."

The research was conducted in collaboration with Sumit Majumdar and Jasjeet Minhas-Sandhu from the U of A's Faculty of Medicine & Dentistry and Thomas Marrie from Dalhousie University.

Funding for Dean Eurich's research was provided by a Canada Research Chair award and Alberta Innovates - Health Solutions. Sumit Majumdar also receives salary support from Alberta Innovates - Health Solutions.