{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T16:28:05Z","timestamp":1777307285577,"version":"3.51.4"},"reference-count":53,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,6,17]],"date-time":"2013-06-17T00:00:00Z","timestamp":1371427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify novel modifiable risk factors, focusing on oral hygiene, for pneumonia requiring hospitalization of community\u2010dwelling older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      Memphis,\n                      <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\n                      ennessee, and\n                      <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\n                      ittsburgh,\n                      <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\n                      ennsylvania.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Of 3,075 well\u2010functioning community\u2010dwelling adults aged 70 to 79 enrolled in the Health, Aging, and Body Composition Study from 1997 to 1998, 1,441 had complete data in the data set of all variables used, a dental examination within 6\u00a0months of baseline, and were eligible for this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The primary outcome was pneumonia requiring hospitalization through 2008.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1,441 participants, 193 were hospitalized for pneumonia. In a multivariable model, male sex (hazard ratio (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      )\u00a0=\u00a02.07, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      )\u00a0=\u00a01.51\u20132.83), white race (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.44, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.03\u20132.01), history of pneumonia (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a03.09, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.86\u20135.14), pack\u2010years of smoking (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.006, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.001\u20131.011), and percentage of predicted forced expiratory volume in 1\u00a0minute (moderate vs mild lung disease or normal lung function,\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.78, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.28\u20132.48; severe lung disease vs mild lung disease or normal lung function,\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a02.90, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.51\u20135.57) were nonmodifiable risk factors for pneumonia. Incident mobility limitation (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.77, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.32\u20132.38) and higher mean oral plaque score (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.29, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.02\u20131.64) were modifiable risk factors for pneumonia. Average attributable fractions revealed that 11.5% of cases of pneumonia were attributed to incident mobility limitation and 10.3% to a mean oral plaque score of 1 or greater.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incident mobility limitation and higher mean oral plaque score were two modifiable risk factors that 22% of pneumonia requiring hospitalization could be attributed to. These data suggest innovative opportunities for pneumonia prevention among community\u2010dwelling older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.12325","type":"journal-article","created":{"date-parts":[[2013,6,17]],"date-time":"2013-06-17T13:40:40Z","timestamp":1371476440000},"page":"1111-1118","source":"Crossref","is-referenced-by-count":59,"title":["Modifiable Risk Factors for Pneumonia Requiring Hospitalization of Community\u2010Dwelling Older Adults: The Health, Aging, and Body Composition Study"],"prefix":"10.1111","volume":"61","author":[{"given":"Manisha","family":"Juthani\u2010Mehta","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases Department of Internal Medicine School of Medicine Yale University New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"De Rekeneire","sequence":"additional","affiliation":[{"name":"Section of Geriatrics Department of Internal Medicine School 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