title: A study of the impact of influenza on the functional status of frail older people.
abstract: BACKGROUND
  Excess hospitalization and death are well-known impacts of influenza on older people; however, little is known regarding the impact of influenza on functional status. We hypothesized that frail older people are at risk of functional decline as an outcome of influenza.
  
  
  OBJECTIVE
  To measure the effect of acute influenza on the physical and mental status of older patients residing in nursing homes.
  
  
  METHODS
  Our study was conducted in 6 nursing homes that participated in the Medicare Influenza Vaccine Demonstration and experienced laboratory-confirmed outbreaks of influenza in 1991 and 1992. A case-comparison design was used. One hundred sixteen of 131 residents who developed influenza-like illness and survived at least 4 months served as the case subjects; 127 of 132 residents without influenza-like illness who survived served as the comparison subjects. Measures of functional status 1 to 2 months before outbreak and 1 to 2 months and 3 to 4 months after outbreak were collected from medical records. Matched pairs analyses were conducted to ascertain changes in selected measures of functional status within each of the study groups. Wilcoxon signed rank tests for statistical significance were used.
  
  
  RESULTS
  Among surviving case subjects and comparison subjects, 25% and 15.7%, respectively, experienced decline in at least 1 major function (P=.04). Case subjects experienced significant decline in independence in bathing, dressing, and mobility while comparison subjects experienced decline in mental status.
  
  
  CONCLUSIONS
  Within the limitations of this study, influenza is observed to cause decline in major physical functions in more than 9% of survivors. Such disabling outcomes constitute an important new measure of impact of influenza on the frail elderly.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester Medical Center, NY 14642, USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Barker
authors.forename: H
authors.initials: H
authors.lastname: Borisute
authors.forename: C
authors.initials: C
authors.lastname: Cox
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D006707:Homes for the Aged; D006801:Humans; D007251:Influenza, Human / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes