Presentation (CTI)

OBJECTIVES: Emerging evidence suggests a link between Alzheimer’s disease (AD) and infection. This study evaluated whether individuals with AD have a higher risk of infections compared with those without AD, across nursing home and community settings.
METHODS: This retrospective cohort study included adults aged ≥65 years who were continuously enrolled in Oracle Life Sciences closed claims data from September 2022 through May 2024. Patients with an AD diagnosis during baseline (September 2022-August 2023) comprised the AD group, while those without an AD diagnosis during baseline or follow-up (September 2023-May 2024) comprised the non-AD group. Exposure groups were further stratified by care setting (nursing home or community-dwelling) based on the presence of a healthcare visit in a nursing home during baseline or follow-up. During follow-up, risks of COVID-19, RSV, influenza, pneumonia, and meningitis were assessed and compared between exposure groups using risk ratios.
RESULTS: Patients with AD were older than those without AD in both nursing home (mean age: 77 vs. 73 years) and community settings (76 vs. 72 years). In the community, risk of all infections were 1.5-5.2 times higher among AD patients compared with non-AD patients (all p<0.001). Infection risks were higher in nursing homes than in the community (1.5-3.4 times higher among AD patients and 2.5-7.8 times higher among non-AD patients; all p<0.05). Within nursing homes, the risk of COVID-19 was significantly higher among patients with AD compared with non-AD patients (17.3% vs. 13.4%; p<0.001), whereas the risk of pneumonia was significantly lower among patients with AD (14.1% vs. 17.0%; p<0.001).
CONCLUSIONS: AD patients exhibited a higher risk of infection in community settings, and residence in a nursing home was associated with additional risks. These findings highlight the need for targeted infection-prevention strategies among AD patients, with enhanced protections for those residing in nursing homes.