{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T02:02:31Z","timestamp":1780452151497,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Dementia and aspiration pneumonia are common and debilitating conditions in older adults. While both are significant contributors to morbidity and mortality, the interaction between these conditions remains inadequately understood. This study aimed to explore the bidirectional relationship between dementia and aspiration pneumonia and to assess its impact on cognitive decline in older patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort analysis of 500 elderly dementia patients at a tertiary care center (2018\u2010\u20102022) was conducted, and participants were classified by aspiration pneumonia occurrence. Cognitive function was assessed via the Mini\u2010Mental State Examination (MMSE) at baseline and follow\u2010up, with Kaplan\u2013Meier analysis evaluating time\u2010to\u2010pneumonia and Cox regression modeling of bidirectional relationships while adjusting for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 500 dementia patients (mean age 78.3\u2009\u00b1\u20097.2\u2009years), Kaplan\u2013Meier analysis revealed significantly earlier pneumonia onset in severe dementia patients (log\u2010rank\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), with Cox regression showing that severe dementia conferred triple the pneumonia risk (hazard ratio [HR]\u2009=\u20093.01, 95% confidence interval [CI]: 2.15\u20134.21) and that swallowing dysfunction independently increased the hazard ratio 3.45\u2010fold (95% CI: 2.61\u20134.55); aspiration pneumonia accelerated cognitive decline (\u03b2\u2009=\u2009\u22122.35, 95% CI: \u22123.12 to \u22121.58).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study revealed that dementia severity substantially increases time\u2010dependent pneumonia hazard (severe dementia HR\u2009=\u20093.01), while pneumonia accelerates cognitive deterioration, forming a bidirectional cycle amplified by swallowing dysfunction. Early dysphagia management and pneumonia prevention strategies are crucial for disrupting this progression in older adults.\n                      <jats:bold>Geriatr Gerontol Int 2025; 25: 1481\u20131487<\/jats:bold>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70176","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T05:39:48Z","timestamp":1758260388000},"page":"1481-1487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bidirectional impact of dementia and aspiration pneumonia on cognitive decline in older adults: A retrospective cohort analysis"],"prefix":"10.1111","volume":"25","author":[{"given":"Junsong","family":"Xu","sequence":"first","affiliation":[{"name":"PLA 117 Clinical College, Anhui Medical University  Hefei China"},{"name":"Department of Geriatrics No. 903 Hospital of PLA Joint Logistics Support Force  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Geriatrics No. 903 Hospital of PLA Joint Logistics Support Force  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine No. 903 Hospital of PLA Joint Logistics Support Force  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Geriatrics No. 903 Hospital of PLA Joint Logistics Support Force  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuquan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Geriatrics No. 903 Hospital of PLA Joint Logistics Support Force  Hangzhou 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