Cellular immunity amongst the elderly with non-hospital acquired pneumonia diminishes both quantitatively and qualitatively. Nevertheless, the cellular immunosupression detected in these patients is reversible and improves with time.

30% mortality

In the past few decades there has been a significant and progressive increase in the number of elderly people and so there is a greater number of illnesses such as pneumonia. The problem arises because pneumonia amongst the elderly (PAE) has a high mortality rate – about 30% – the prime cause of death through infectious disease amongst the elderly.

The underlying causes of these rates are related to immunosenescence, simply the natural process of ageing and the deterioration of the immune system. A deterioration which is augmented by chronic or acute pathological events such as pneumonia and also, apparently, by malnutrition.

This is why acute immunosupression in addition to the process of immunosenescence may well affect the mortality rates of PAE and of patients who have overcome pneumonia.

It is to this aspect that doctor Humberto Mendoza has directed his thesis having, as its objective, analysis of the complete immunological situation of the non-hospital acquired pneumonia in the elderly patient who has to be admitted to hospital. Moreover, the analytical data about immunity on hospitalisation were compared with that after release, with the aim of studying possible post-hospital recovery.

Finally, it was wished that the effect of nutrition on ease and quality of life be monitored and so, nutritional data was studied for admission and post hospital periods in order to see if nutrition influences the recovery and survival of the patient.

Patients hospitalised at the Virgen del Camino Hospital

In order to carry out the study, a sample patients over 65 with non-hospital acquired pneumonia and admitted to the Internal Medicine wing of the Virgen del Camino Hospital between 1996 and 1998 was taken.

Initial data taken on these patients included a study of general aspects – analytical, microbiological, radiological and other variables related to immunity, nutrition or Kataz and Karnofsky life quality index values. Furthermore, follow-up studies on these values were carried out.

Humberto Mendoza has analysed these data and drawn the conclusion that, although, cellular immunity amongst the elderly with non-hospital acquired pneumonia clearly diminishes both quantitatively and qualitatively, this immunosupression is reversible and improves with time.

Finally, no relation has been found between the immunity data and nutrition parameters. On the other hand, malnutrition has a significant influence in the mortality of patients admitted, while it does not appear to influence immunity values in any marked way.