Abstract
BACKGROUND: Pneumonia is an important cause of death in patients with Alzheimer's disease (AD), and understanding the factors associated with hospital-acquired pneumonia (HAP) is essential for preventing the development of HAP in AD patients. This study aimed to elucidate the specific risk factors related to HAP in AD patients based on gender differences. METHODS: A total of 1066 patients with Alzheimer's disease (483 males, 583 females), who were admitted to a large psychiatric hospital for the first time between 2013 and 2023, were included in the study. The association between HAP and patients' personal characteristics, medication use and blood test results among genders was analysed. Finally, binary logistic regression was used to identify the independent risk factors for men and women. RESULTS: The infection rate of HAP in male AD patients was significantly higher than that in females, at 41.8% and 23.3%, respectively (χ(2) = 41.726, P < 0.001). Regression results showed that in male patients, HAP was independently correlated with age, apolipoprotein A1 level and lymphocyte count, whereas in female patients, HAP was independently correlated with age, albumin, low-density lipoprotein cholesterol and neutrophil count. CONCLUSION: This study suggests that older AD patients are more susceptible to HAP; the infection rate of HAP in male patients with Alzheimer's disease is higher than that in females, and there are differences in the factors associated with the occurrence of HAP between male and female patients. It is suggested that prevention and treatment strategies for hospital-acquired pneumonia in individuals with Alzheimer's disease could consider age and gender differences.