Older meningitis patients more likely to die

NEW YORK (Reuters Health) - Older people with bacterial meningitis have a higher incidence of complications, illness and death, relative to their younger counterparts, a new study hints.

"Older age remains an independent risk factor for adverse outcome," conclude Dr. Martijn Weisfelt and colleagues from Academic Medical Center, Amsterdam.

Bacterial meningitis occurs when meningococcal or other bacteria cause an inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. Symptoms such as headache, intolerance to light, a stiff neck, and vomiting can develop rapidly. The infection can be life threatening and urgent treatment with antibiotics is essential.

While many people carry meningococcal bacteria around in their nose or throat, as few as 1 in 100,000 goes on to develop serious infections.

In their study, Weisfelt's team examined the clinical features of bacterial meningitis in a group of patients at least 60 years of age and a group of younger patients between 17 to 59 years of age.

Out of 696 episodes of the illness, 257 (37 percent) were in elderly patients and 439 (63 percent) were in younger adults. Fifty-eight percent of older patients presented with the triad of fever, neck stiffness and altered mental status, compared with 36 percent of younger adults.

Older patients were significantly more likely to develop complications than younger patients (72 percent versus 57 percent, respectively). The death rate was much higher in older patients than in younger patients (34 percent versus 13 percent).

Elderly patients tended to die more often from cardiorespiratory failure (25 percent versus 11 percent of younger patients), and younger patients tended to die more often from brain herniation (23 percent versus 2 percent).

SOURCE: The Journal of the American Geriatrics Society, October 2006.