Abstract
Aspiration Pneumonia (AP) and Diffuse Aspiration Bronchiolitis (DAB) are often found in elderly, debilitated patients with dysphagia. The prevalence of AP in hospitals and nursing homes is rapidly expanding. The incidence of AP to total pneumonia is very high in elderly patients aged 70 years and older. For the diagnosis of AP or DAB, the evaluation of swallowing function is important. Food aspiration alone may cause DAB, but not always cause AP. Two different therapeutic approaches such as antibiotics administration and swallowing rehabilitation with oral hygiene are necessary for the cure of AP. Drugs that improve the swallowing reflex, vaccinations and oral health care management are effective in preventing aspiration pneumonia; however, percutaneous endoscopic gastrostomy is not recommended for the purpose of preventing aspiration pneumonia. The proper management of AP and DAB may be a central issue of geriatric medicine.
Highlights
Pneumonia is the leading cause of death in developed countries including Japan, and most of the deaths from pneumonia occur in patients older than 65 years of age [1,2,3]
The developed countries are facing the advent of an unprecedented aging of society, and the field of nursing and the prevalence of aspiration pneumonia in both nursing homes and healthcare facilities are rapidly expanding [3,4,5]
We described the clinical significance, the mechanism, and therapeutic strategy of aspiration pneumonia distinct from conventional community acquired pneumonia in the aging population
Summary
Pneumonia is the leading cause of death in developed countries including Japan, and most of the deaths from pneumonia occur in patients older than 65 years of age [1,2,3]. The incidence and the prevalence of aspiration pneumonia (AP) in the community are poorly defined. It increases in direct relation with age and underlying diseases [7,8,9,10]. In our prospective one-year study, most of the patients hospitalized for pneumonia were elderly patients who are 70 years and older [10]. The incidence of AP in overall hospitalized communityacquired pneumonia (CAP) was 60.1% (264/439 cases). Since the patients treated in hospitals and nursing homes are getting older and older, the incidence of AP may be quite high, which had not been previously expected
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