Sepsis Takes a Lasting Toll on Lifestyle and Memory
Sepsis that is infection of the bloodstream that causes life-threatening illness leaves many older patients with disability and memory deficits and is now targeted as a public health concern. Researchers say cognitive impairment that follow sepsis in 60 percent of elders leads to years of problems.
The findings from University of Michigan Health System, published in the Journal of the American Medical Association show older patients hospitalized with sepsis are 3.3 times more susceptible to cognitive impairment that can limit the ability to perform simple activities of daily living, compared to hospitalization for other types of illness.
The severe infection of the bloodstream that can start anywhere in the body causes low blood pressure and leads to shock. The result is decreased blood supply to the major organs, including the central nervous system. After recovery, researchers found 40 percent of patients who had no physical limitations before infection developed had difficulty walking. One in five patients was found to have difficulty preparing a meal and shopping.
According to Theodore (Jack) Iwashyna, M.D., Ph.D., assistant professor of internal medicine at U-M, “We used to think of sepsis as just a medical emergency, an infection that you get sick with and then recover. But we discovered a significant number of people face years of problems afterwards.”
Sepsis Leads to “Real Brain and Body Problems”
The study author says problems with brain function and disability post-sepsis treatment are “real” and “more common than we expected”, requiring a focus on prevention and better treatment for infection.
Kenneth M. Langa, M.D., Ph.D., a core investigator for the Ann Arbor Veterans Administration Health Services Research and Development Service’s Center of Excellence and professor of internal medicine at U-M says prevention is important. Older individuals need to get their flu and pneumonia vaccines early to prevent infection that can worsen and result in hospitalization from sepsis.
“In contrast to Alzheimer’s disease and other forms of dementia, the cognitive impairment associated with sepsis is likely at least partially preventable through better acute care of the sepsis episode and better rehabilitation efforts afterwards.” Langa says there are innovative approaches that can be used on admission that might help prevent disability.
Older people with weakened immunity are most susceptible to developing bloodstream infection that can start from pneumonia or urinary tract infection. The most recent analysis of the number of individuals affected annually from sepsis is from 1990 that has probably doubled from 750,000 diagnoses each year.
The findings that severe sepsis has a long-term impact on cognition and functional capacity was extracted from the long-term the NIA-supported Health and Retirement Study that measures economic and social well-being of Americans over age 50.
Journal of the American Medical Association, 2010; 304(16): 1787-1794