Serum zinc and pneumonia in nursing home elderly13

Background: Zinc plays an important role in immune function. The association between serum zinc and pneumonia in the elderly has not been studied. Objective: The objective was to determine whether serum zinc concentrations in nursing home elderly are associated with the inci-dence and duration of pneumonia, total and duration of antibiotic use, and pneumonia-associated and all-cause mortality. Design: This observational study was conducted in residents from 33 nursing homes in Boston, MA, who participated in a 1-y random-ized, double-blind, and placebo-controlled vitamin E supplementa-tion trial; all were given daily doses of 50 % of the recommended dietary allowance of essential vitamins and minerals, including zinc. Participants with baseline (n 578) or final (n 420) serum zinc concentrations were categorized as having low (70 g/dL) or normal (70g/dL) serum zinc concentrations. Outcome measures included the incidence and number of days with pneumonia, number of new antibiotic prescriptions, days of antibiotic use, death due to pneumonia, and all-cause mortality. Results: Compared with subjects with low zinc concentrations, subjects with normal final serum zinc concentrations had a lower incidence of pneumonia, fewer (by almost 50%) new antibiotic pre-scriptions, a shorter duration of pneumonia, and fewer days of anti-biotic use (3.9 d compared with 2.6 d) (P 0.004 for all). Normal baseline serum zinc concentrations were associated with a reduction in all-cause mortality (P 0.049). Conclusion: Normal serum zinc concentrations in nursing home elderly are associated with a decreased incidence and duration of pneumonia, a decreased number of new antibiotic prescriptions, and a decrease in the days of antibiotic use. Zinc supplementation to maintain normal serum zinc concentrations in the elderly may help reduce the incidence of pneumonia and associated morbidity. Am J Clin Nutr 2007;86:1167–73. KEY WORDS Serum zinc, nursing home elderly, pneumonia