Wednesday, October 27, 2010
Sepsis has lasting impact on elderly
Sepsis is a medical emergency in which an infection overwhelms the body. Unless antibiotics and life support are delivered quickly, the condition can lead to organ failure and death. Most of those who recover do so gratefully and move on with their lives. However, elderly people who survive a bout of sepsis may not be so lucky.
Research published Tuesday suggests, for the first time, that sepsis can leave some elderly individuals with long-term physical or cognitive problems. Researchers analyzed data from 1,194 elderly patients who were hospitalized with severe sepsis and compared them with 4,517 elderly people who experienced a hospitalization but did not have sepsis. Examining data from up to eight years after the hospitalization, the researchers found sepsis patients had a threefold higher risk for developing cognitive problems, such as forgetfulness, compared with the people who were hospitalized for other reasons. Moreover, the sepsis patients were more likely to have at least one new physical limitation, such as walking, dressing or bathing, after the hospitalization.
"[A]n episode of severe sepsis, even when survived, may represent a sentinel event in the lives of patients and their families, resulting in new and often persistent disability, in some cases even resembling dementia," the authors wrote.
It's not uncommon for elderly people to experience some long-term effects from a hospitalization. But the much higher rate of subsequent functional problems in sepsis patients suggests there is something about the illness that takes a particular toll on an older person. It's likely that the effect of the infection can degrade muscle fibers to the extent that the patient's physical strength declines. How sepsis contributes to dementia is less clear. It could be that the massive inflammation that occurs with sepsis causes some brain damage, the authors wrote. Delirium is common in severe sepsis, and delirium has been linked with an increase in cognitive decline in people with Alzheimer's disease.
If these data are accurate, sepsis in people age 65 and older could cause about 20,000 new cases of dementia each year, the authors wrote. More effort is needed to follow elderly survivors of sepsis that might help them recover more fully and avoid long-term repercussions of the illness, the authors said. The study was published in the Journal of the American Medical Assn.