Abstract
The ability to predict upper respiratory infections (URI), lower respiratory infections (LRI), and gastrointestinal tract infections (GI) in independently living older persons would greatly benefit population and individual health. Social network parameters have so far not been included in prediction models. Data were obtained from The Maastricht Study, a population-based cohort study (N = 3074, mean age (±s.d.) 59.8 ± 8.3, 48.8% women). We used multivariable logistic regression analysis to develop prediction models for self-reported symptomatic URI, LRI, and GI (past 2 months). We determined performance of the models by quantifying measures of discriminative ability and calibration. Overall, 953 individuals (31.0%) reported URI, 349 (11.4%) LRI, and 380 (12.4%) GI. The area under the curve was 64.7% (95% confidence interval (CI) 62.6-66.8%) for URI, 71.1% (95% CI 68.4-73.8) for LRI, and 64.2% (95% CI 61.3-67.1%) for GI. All models had good calibration (based on visual inspection of calibration plot, and Hosmer-Lemeshow goodness-of-fit test). Social network parameters were strong predictors for URI, LRI, and GI. Using social network parameters in prediction models for URI, LRI, and GI seems highly promising. Such parameters may be used as potential determinants that can be addressed in a practical intervention in older persons, or in a predictive tool to compute an individual's probability of infections.
Highlights
IntroductionPopulation ageing has become a global issue [1]. Worldwide, the proportion of people aged 60 and over is growing rapidly, and it is expected to rise to one-quarter of the populations in Europe and North America in 2020 [1, 2].Infectious diseases are a major challenge in healthcare of the older persons [3], due to increased susceptibility to infections caused by an age-related compromised immune system [4]
Over the last decade, population ageing has become a global issue [1]
The aim of the current study was to develop and internally validate prediction models for upper respiratory infections (URI), lower respiratory infections (LRI), and gastrointestinal tract infections (GI) in a large group of independently living middle-aged and older persons based on a range of variables including social network parameters
Summary
Population ageing has become a global issue [1]. Worldwide, the proportion of people aged 60 and over is growing rapidly, and it is expected to rise to one-quarter of the populations in Europe and North America in 2020 [1, 2].Infectious diseases are a major challenge in healthcare of the older persons [3], due to increased susceptibility to infections caused by an age-related compromised immune system [4]. Population ageing has become a global issue [1]. The proportion of people aged 60 and over is growing rapidly, and it is expected to rise to one-quarter of the populations in Europe and North America in 2020 [1, 2]. Infectious diseases are a major challenge in healthcare of the older persons [3], due to increased susceptibility to infections caused by an age-related compromised immune system [4]. Older persons have decreased cell-mediated immunity and decreased antibody production to new antigens [3, 5]. Pneumonia and influenza are among the 10 major causes of death in the older persons [3]. The incidence and severity of community-acquired upper respiratory
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