ArticleAmerican journal of respiratory and critical care medicine2013
Bidirectional relationship between cognitive function and pneumonia.
Article in American journal of respiratory and critical care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03865602 (Improving Morbidity During Post-Acute Care Transitions for Sepsis), which is not on this map. Cited by 120 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Morbidity During Post-Acute Care Transitions for Sepsis (IMPACTS): A Pragmatic Randomized Evaluation of Implementing Best Practice Care for Sepsis Survivors to Reduce Morbidity and Mortality
Who cites it
120 citing papers in PubMed, 7 syntheses or guidelines pooled it, 219 citations in OpenAlex.
- Does pneumonia increase the risk of dementia and cognitive decline? A systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Hospitalization with infections and risk of Dementia: a systematic review and meta-analysis.Aging · 2025Pooled it
- Effects of different dosages/frequency of Xuebijing injection (a Chinese patent) for sepsis: a network meta-analysis of randomized controlled trials.Frontiers in medicine · 2025Pooled it
- Risk of Dementia or Cognitive Impairment in Sepsis Survivals: A Systematic Review and Meta-Analysis.Frontiers in aging neuroscience · 2022Pooled it
- Common Bacterial Infections and Risk of Dementia or Cognitive Decline: A Systematic Review.Journal of Alzheimer's disease : JAD · 2020Pooled it
- Understanding and Enhancing Sepsis Survivorship. Priorities for Research and Practice.American journal of respiratory and critical care medicine · 2019Pooled it
- Diagnoses of early and late readmissions after hospitalization for pneumonia. A systematic review.Annals of the American Thoracic Society · 2014Pooled it
- Neuropsychological, neuropsychiatric, and quality-of-life assessments in Alzheimer's disease patients treated with plasma exchange with albumin replacement from the randomized AMBAR study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2022Trial
- Long-Term Quality of Life Among Survivors of Severe Sepsis: Analyses of Two International Trials.Critical care medicine · 2016Trial
- The influence of hospitalization or intensive care unit admission on declines in health-related quality of life.Annals of the American Thoracic Society · 2015Trial
- Infection hospitalization increases risk of dementia in the elderly.Critical care medicine · 2014Trial
- Severe infections, domain-specific cognitive vulnerability, and future infection risk in older adults.Brain, behavior, & immunity - health · 2026Article
- Bloodstream infections and Blood-Brain barrier Permeability: An observational cohort study.Brain, behavior, and immunity · 2026Observational
- Barrier breakdown: lung-brain crosstalk in systemic inflammation.Journal of neuroinflammation · 2026Review
- The lung-brain axis: elucidating the mechanisms of pulmonary-driven neurological disorders.Journal of neuroinflammation · 2026Review
- The role of noninfectious comorbidities in the association between severe infections and risk of dementia in Finland: A nationwide registry study.PLoS medicine · 2026Article
- Neuroimmune Mechanisms Transforming Acute Injury to Long-Term Brain Dysfunction After Sepsis.Clinics in chest medicine · 2026Review
- Pneumonia Risk in Institutionalized Older Adults With Severe Functional Dependency: An Exploratory Analysis Using Standardized Long-Term Care Assessment Data.Geriatrics & gerontology international · 2026Observational
- Tau is necessary for Pseudomonas aeruginosa-induced blood-brain barrier dysfunction.Communications biology · 2026Article
- Influenza A infection accelerates disease-associated microglia formation during physiological aging.bioRxiv : the preprint server for biology · 2025Article
60 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors at 9 institutions in 1 country.
Funding
Abstract
rationaleRelationships between chronic health conditions and acute infections remain poorly understood. Preclinical studies suggest crosstalk between nervous and immune systems.
objectivesTo determine bidirectional relationships between cognition and pneumonia.
methodsWe conducted longitudinal analyses of a population-based cohort over 10 years. We determined whether changes in cognition increase risk of pneumonia hospitalization by trajectory analyses and joint modeling. We then determined whether pneumonia hospitalization increased risk of subsequent dementia using a Cox model with pneumonia as a time-varying covariate. MEASUREMENTS AND MAIN
resultsOf the 5,888 participants, 639 (10.9%) were hospitalized with pneumonia at least once. Most participants had normal cognition before pneumonia. Three cognition trajectories were identified: no, minimal, and severe rapid decline. A greater proportion of participants hospitalized with pneumonia were on trajectories of minimal or severe decline before occurrence of pneumonia compared with those never hospitalized with pneumonia (proportion with no, minimal, and severe decline were 67.1%, 22.8%, and 10.0% vs. 76.0%, 19.3%, and 4.6% for participants with and without pneumonia, respectively; P < 0.001). Small subclinical changes in cognition increased risk of pneumonia, even in those with normal cognition and physical function before pneumonia (β = -0.02; P < 0.001). Participants with pneumonia were subsequently at an increased risk of dementia (hazard ratio, 2.24 [95% confidence interval, 1.62-3.11]; P = 0.01). Associations were independent of demographics, health behaviors, other chronic conditions, and physical function. Bidirectional relationship did not vary based on severity of disease, and similar associations were noted for those with severe sepsis and other infections.
conclusionsA bidirectional relationship exists between pneumonia and cognition and may explain how a single episode of infection in well-appearing older individuals accelerates decline in chronic health conditions and loss of functional independence.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.