Fernandez-Cotarelo, Maria-JoseNagy-Agren, Stephanie ESmolkin, Mark EJimenez-Diez-Canseco, LeticiaPerez-Pomata, Maria-TeresaShenal, Brian VWarren, Cirle A2024-01-292024-01-292019-03-19Fernandez-Cotarelo MJ, Nagy-Agren SE, Smolkin ME, Jimenez-Diez-Canseco L, Perez-Pomata MT, Shenal BV, Warren CA. Functional and Cognitive Status in Clostridium difficile Infection in the Hospitalized Elderly: a Retrospective Study of Two Sites. J Gen Intern Med. 2019 Aug;34(8):1392-1393. doi: 10.1007/s11606-019-04935-6. PMID: 30891689; PMCID: PMC6667591.0884-8734https://hdl.handle.net/10115/29123The gut microbiota composition changes with aging, contributing to risk for Clostridium difficile infection (CDI), and there is evidence of cognitive impairment due to antibiotic-induced gut dysbiosis. However, there is little data about the relationship between functional or cognitive status and CDI. The objective of this study was to determine the association between CDI and functional and/or cognitive status in older patients. Multisite, collaborative international retrospective case-control study. The study was performed at Salem Veterans Affairs Medical Center (Virginia, US), and Hospital Universitario de Mostoles (Madrid, Spain). Participants: Cases were hospitalized patients >60yo with CDI during 2013-2014. Controls were matched to cases by age, sex, and Charlson comorbidity index score (CCI). Measurements: Pre-hospitalization dwelling, CCI, cognitive conditions, functional status, CDI case definition and severity, length of stay, delirium, discharge disposition, readmissions, in-hospital and late mortality. 106 cases were identified, mean age 76.3, mean CCI 3.67. There was significantly increased baseline functional debility and admission from nursing home (NH) or long term care facility (LTCF) in cases, and significantly increased delirium. Cases with delirium had increased death during admission, and cases with cognitive impairment had increased functional decline or death at discharge, and late mortality. We observed significantly increased functional decline or death at discharge, and discharge to a NH, LTCF or death in cases. The combined length of stay and survival outcome was significantly worse for cases, and late mortality at 90 and 180 days was increased. CDI in older patients is associated with functional decline, cognitive impairment and death (including late mortality). These observations emphasize need to address functional and cognitive issues impacting susceptibility and outcomes of CDI in the older host.NoengClostridioides difficile infectionCognitive impairmentElderlyFunctional debilityGut microbiotainfo:eu-repo/semantics/article10.1007/s11606-019-04935-6info:eu-repo/semantics/restrictedAccess