COGNITIVE FUNCTION FOLLOWING PNEUMOCOCCAL AND ALL-CAUSE PNEUMONIA: RESULTS FROM THE PNEUMO STUDY (ID 353)
- Jin H. Han, United States of America
- Jin H. Han, United States of America
- Christopher J. Lindsell, United States of America
- Nadine Rouphael, United States of America
- Kelly D. Johnson, United States of America
- Cynthia G. Whitney, United States of America
- Matthew Phillips, United States of America
- Inci Yildirim, United States of America
- Laurel R. Bristow, United States of America
- Adrienne Baughman, United States of America
- Christopher Gray, United States of America
- Evan Anderson, United States of America
- Laila Hussaini, United States of America
- Kimberly Hart, United States of America
- Wu Gong, United States of America
- Lyn Finelli, United States of America
- Carlos Grijalva, United States of America
- Wesley H. Self, United States of America
Abstract
Background
Systemic inflammation from pneumonia may lead to acute brain dysfunction and long-term cognitive impairment, especially in older patients with severe pneumonia.
Methods
As part of the ongoing Pneumococcal Pneumonia Epidemiology, Urine Serotyping, and Mental Outcomes (PNEUMO) study, we prospectively enrolled adults hospitalized with community-acquired pneumonia. We tested for Streptococcus pneumoniae with cultures and BinaxNOW urinary antigen tests. We assessed global cognition in patients ≥50 years old with the Montreal Cognitive Assessment-Blind Adaptation (MoCA-Blind). MoCA-Blind scores range from 0 to 22 with higher scores indicating better cognition. Adults with a MoCA-Blind score <18 are considered to have cognitive impairment. We administered the MoCA-Blind instrument at enrollment when the patient was acutely ill and 6-months later by phone.
Results
At the time of this interim analysis, 150 patients had cognitive assessments completed at enrollment and 6-months, including 12 (8.0%) with pneumococcal pneumonia. Median (IQR) age was 64 (58-71) years. Cognitive impairment was common at both enrollment and 6-months later (Figure). At 6-month follow-up, 58% of pneumococcal and 52% of non-pneumococcal pneumonia patients had a MoCA-Blind score <18.
Conclusions
Hospitalization for pneumonia, including pneumococcal pneumonia, is associated with high risk of acute and persistent cognitive impairment among US adults ≥50 years old.