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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #210502
Title: Serum zinc and pneumonia in nursing home elderly

Author
item Meydani, Simin
item BARNETT, JUNAIDAH - TUFTS/HNRCA
item Dallal, Gerald
item FINE, BASIL - MT. AUBURN HOSPITAL, MA
item Jacques, Paul
item LEKA, LYNETTE - TUFTS/HNRCA
item HAMER, DAVIDSON - BU INTERNATIONAL HEALTH

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/30/2007
Publication Date: 10/1/2007
Citation: Meydani, S., Barnett, J.B., Dallal, G., Fine, B.C., Jacques, P., Leka, L.S., Hamer, D.H. 2007. Serum zinc and pneumonia in nursing home elderly. American Journal of Clinical Nutrition. 86:1167-73.

Interpretive Summary: Pneumonia is a major public health problem in the elderly. An important factor in incidence of infections like pneumonia in the elderly is the age-associated decline in immune function, which contributes to the increased frequency, severity, and death from pneumonia in the elderly. Zinc is important role to the function of the immune system. The study’s aim was to determine if serum zinc concentrations in nursing home elderly are associated with incidence and duration of pneumonia, duration of antibiotic use, and pneumonia-associated and overall deaths. This observational study was conducted in residents from 33 nursing homes in Boston, MA, who participated in a one-year trial for Vitamin E supplementation and its effect on respiratory infections. They were all were given daily doses of half the recommended daily amounts of essential vitamins and minerals including zinc. Outcome measures included incidence and number of days with pneumonia, number of new antibiotic prescriptions, days of antibiotic use, death due to pneumonia, and, all-cause mortality. Results were that elderly with normal final serum zinc concentrations had lower pneumonia incidence, lower total antibiotic use by almost 50 percent, and shorter duration of pneumonia and antibiotic use compared to those with low zinc concentrations. Further, normal baseline serum zinc concentrations were associated with decreased deaths from all causes. The results from our current study suggest that elderly with low serum zinc concentrations might benefit from zinc supplementation. Such a measure has the potential to reduce not only the number of episodes and duration of pneumonia and the total and duration of antibiotic use due to pneumonia, but also overall deaths in the elderly as a potential low cost intervention to reduce morbidity and mortality due to pneumonia in this vulnerable population.

Technical Abstract: Zinc plays an important role in immune function. The association between serum zinc and pneumonia in the elderly has not been studied. The study aim is to determine if serum zinc concentrations in nursing home elderly are associated with incidence and duration of pneumonia, total and duration of antibiotic use, and pneumonia-associated and overall deaths. This observational study was conducted in residents from 33 nursing homes in Boston, MA, who participated in a one-year randomized, double-blind, and placebo controlled vitamin E supplementation trial; all were given daily doses of one half RDA of essential vitamins and minerals including zinc. Participants with baseline (N=578) or final (N=420) serum zinc concentrations were categorized as having low (less than70 microg/dL) or normal (greater or equal to 70 microg/dL) serum zinc concentrations. Outcome measures included incidence and number of days with pneumonia, number of new antibiotic prescriptions, days of antibiotic use, death due to pneumonia, and, all-cause mortality. Subjects with normal final serum zinc concentrations had lower pneumonia incidence, total antibiotic use (by almost 50 percent), and shorter duration of pneumonia and antibiotic use (by 3.9 and 2.6 days, respectively) (all p-values less than or equal to 0.004) relative to those with low zinc concentrations. Normal baseline serum zinc concentrations were associated with decreased all-cause mortality (p=0.049). Normal serum zinc concentrations in nursing home elderly were associated with decreased incidence and duration of pneumonia, and decreased use and duration of antimicrobial therapy. Zinc supplementation to maintain normal serum zinc concentrations in the elderly may help reduce pneumonia incidence and associated morbidity.