CHANGES IN PHYSICAL AND COGNITIVE STATUS FOLLOWING HOSPITALIZATION FOR RESPIRATORY TRACT INFECTIONS IN OLDER ADULTS: A POPULATION-BASED STUDY USING JAPANESE ADMINISTRATIVE DATA
Author(s)
Ryosuke Uemura, MHA, MD, Haruhisa Fukuda, MPH, PhD.
Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
OBJECTIVES: To characterize the functional consequences of respiratory tract infections (RTIs), we examined changes in activities of daily living (ADL) and cognitive status before and after RTI-related hospitalization in an older Japanese population.
METHODS: This study utilized data from the Longevity Improvement & Fair Evidence (LIFE) Study, an ongoing database project that collects medical and long-term care claims data from multiple Japanese municipalities. Among residents aged ≥65 years across 10 municipalities, we identified RTI-related hospitalizations (case group) that occurred in fiscal year 2018. We examined changes in each individual’s ADL (scores 1-9, with higher values indicating greater impairment) and cognitive status (scores 1-8) as continuous variables from one year before to one year after hospitalization. To account for background temporal trends in these outcomes, we established a control group of participants without RTIs, using October 2018 as the index date. The impact of RTI-related hospitalization was estimated through a difference-in-differences approach with a mixed-effects model incorporating municipality- and individual-level random intercepts.
RESULTS: Among 359,046 participants from 10 municipalities, 8,699 RTI-related hospitalized cases were identified. In the case group, the mean age was 81.3 years and 54.8% were women. The mean within-individual changes following RTI-related hospitalization were 0.68 (P < 0.001) for ADL and 0.30 (P < 0.001) for cognitive status. In the difference-in-differences analysis, RTI-related hospitalization was associated with an estimated worsening of 0.58 (95% confidence interval: 0.56-0.60) in ADL and 0.24 (0.23-0.26) in cognitive status. Age-stratified analyses showed greater deterioration in older age groups.
CONCLUSIONS: This large-scale pre-post assessment based on Japanese healthcare claims data suggests that RTI-related hospitalizations have a substantial adverse impact on physical and cognitive function. These findings highlight the importance of RTI prevention strategies, particularly among older adults.
METHODS: This study utilized data from the Longevity Improvement & Fair Evidence (LIFE) Study, an ongoing database project that collects medical and long-term care claims data from multiple Japanese municipalities. Among residents aged ≥65 years across 10 municipalities, we identified RTI-related hospitalizations (case group) that occurred in fiscal year 2018. We examined changes in each individual’s ADL (scores 1-9, with higher values indicating greater impairment) and cognitive status (scores 1-8) as continuous variables from one year before to one year after hospitalization. To account for background temporal trends in these outcomes, we established a control group of participants without RTIs, using October 2018 as the index date. The impact of RTI-related hospitalization was estimated through a difference-in-differences approach with a mixed-effects model incorporating municipality- and individual-level random intercepts.
RESULTS: Among 359,046 participants from 10 municipalities, 8,699 RTI-related hospitalized cases were identified. In the case group, the mean age was 81.3 years and 54.8% were women. The mean within-individual changes following RTI-related hospitalization were 0.68 (P < 0.001) for ADL and 0.30 (P < 0.001) for cognitive status. In the difference-in-differences analysis, RTI-related hospitalization was associated with an estimated worsening of 0.58 (95% confidence interval: 0.56-0.60) in ADL and 0.24 (0.23-0.26) in cognitive status. Age-stratified analyses showed greater deterioration in older age groups.
CONCLUSIONS: This large-scale pre-post assessment based on Japanese healthcare claims data suggests that RTI-related hospitalizations have a substantial adverse impact on physical and cognitive function. These findings highlight the importance of RTI prevention strategies, particularly among older adults.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD86
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)