How to minimize infectious health risks for elderly people (based on focus group data)

View or download the full article: 
616.9-053.9-092.12-084: 301

A. Yagodina, I. Serova, U. Maslov, S. Korotin


Perm State Medical University named after Academician E.A. Wagner, 26 Petropavlovskaya Str., Perm, 614990, Russian Federation


This literature review focuses on practices aimed at mitigating infectious health risks for elderly people in acute care inpatient hospitals with multiple specializations. We revealed a necessity to create medical information centers; common reference centers for PCR diagnostics, sequencing, plasmid analysis, and MULDI-TOF; as well as to provide support and further development of bacteriological and hygienic service in medical and preventive organizations. Our review also dwells on theoretical solutions to issues related to minimizing infection risks in nursing homes and prospective approaches to providing infectious safety at home. A focus group was organized on May 20, 2021 at the E.A. Wagner’s Perm State Medical University of the RF Public Healthcare Ministry with its aim being to implement theoretical approaches into practices of minimizing infectious health risks for elderly people in Perm region within the “aging in place” paradigm. The sociological explication made it possible to fix the regional agenda on minimizing infectious heath risks for elderly people as per three basic directions: by improving living conditions, by improving care provided for elderly people at home, and by making elderly people’s lives more active as a way to support their immunity.

All the discussion participants unanimously agreed both on assigning the primary role to the strengthened immunity as a way to minimize infectious health risks and on obvious absence of any drugs which would be able to resolve the issue. Experts believe adherence to conventional recommendations on how to improve elderly people’s immunity to be fundamental for infection risk mitigation. We should remember that some elderly people live in improper housing which should be renovated and adapted to basic needs of an elderly person. It is also important to develop the city environment taking into account elderly people’s habits and needs (they should be provided with a special place in the yard where they can communicate with each other, play board games or do physical exercises). Financial support should be given to “Inpatient hospital at home” program and to developing tools used to promptly minimize infection risks, for example, telemedicine which allows detecting certain alerting symptoms typical for communicable diseases (fever, complaining about cough and running nose, pains in the lumbar spine, decreased diuresis etc.)

sociology of medicine, infection risks, infectious safety, stereotypes of medical care, elderly patients, transmission routes of hospital acquired infections, vaccination, immunity
Yagodina A., Serova I., Maslov U., Korotin S. How to minimize infectious health risks for elderly people (based on focus group data). Health Risk Analysis, 2022, no. 1, pp. 72–84. DOI: 10.21668/health.risk/2022.1.08.eng
  1. Leibovici L., Samra Z., Konigsberger H., Drucker M., Ashkenazi S., Pitlik S.D. Long-term survival following bacteremia or fungemia. JAMA, 1995, vol. 274, no. 10, pp. 807–812.
  2. Lilie P.J., Allen J., Hall C., Walsh C., Adams K., Thaker H., Moss P., Barlow G.D. Long-term mortality following bloodstream infection. Clin. Microbiol. Infect., 2013, vol. 19, no. 10, pp. 955–960. DOI: 10.1111/1469-0691.12101
  3. Iwashyna T.J., Cooke C.R., Wunsch H., Kahn J.M. The population burden of long-term survivorship after severe sepsis among older Americans. J. Am. Geriatr. Soc., 2012, vol. 60, no. 6, pp. 1070–1077. DOI: 10.1111/j.1532-5415.2012.03989.x
  4. Fatenkov O.V., Kuzmina T.M., Rubanenko O.A., Svetlova G.N., Djubailo A.V. Community acquired bacterial pneumonia and comorbidity in elderly patients. Uspekhi gerontologii, 2017, vol. 30, no. 3, pp. 394–397 (in Russian).
  5. Utenkova E.O., Lyubeznova O.N., Noskova E.V., Noskova V.V. Features of intestinal infections in elderly patients. Uspekhi gerontologii, 2018, vol. 31, no. 2, pp. 246–249 (in Russian).
  6. Birnbaum M., Booth W. Nursing homes linked to up to half of coronavirus deaths in Europe, WHO says. The Washington Post, 2020. Available at: (30.07.2021).
  7. Coronavirus (COVID-19) latest insights. Office for National Statistics. Available at: https://¬populationandcommunity/healthandsocialcare/conditionsanddi-seases/articles/coro¬¬naviruscovid19roundup/2020-03-26 (30.07.2021).
  8. Graham N.S.N., Junghans С., Downes R., Sendall C., Lai H., McKirdy A., Elliott P., Howard R. [et al.]. SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes. J. Infect., 2020, vol. 81, no. 3, pp. 411–419. DOI: 10.1016/j.jinf.2020.05.073
  9. COVID Data Tracker. CDC. Available at:¬nation (22.02.2022).
  10. Castelo-Branco C., Soveral I. The immune system and aging: a review. Gynecol. Endocri-nol., 2014, vol. 30, no. 1, pp. 16–22. DOI: 10.3109/09513590.2013.852531
  11. Rabinow P. Sociobiology and Biosociality. In: G.B. Yudin translation. Chelovek, 2019, vol. 30, no. 6, pp. 8–26 (in Russian).
  12. Big С., Malani P.N. Staphylococcus aureus bloodstream infections in older adults: clinical outcomes and risk factors for in-hospital mortality. J. Am. Geriatr. Soc., 2010, vol. 58, no. 2, pp. 300–305. DOI: 10.1111/j.1532-5415.2009.02666.x
  13. Ratsional'naya antibiotikoterapiya: vzglyad i kommentarii spetsialistov [Rational antibiotic therapy: view and comments of specialists]. Effektivnaya farmakoterapiya, 2017, no. 3, pp. 60–66 (in Russian).
  14. Ratsional'naya antibiotikoterapiya: effektivnaya i adekvatnaya [Rational antibiotic therapy: effective and adequate]. Effektivnaya farmakoterapiya, 2017, no. 15, pp. 24–35 (in Russian).
  15. Bokeriya L.A., Beloborodova N.V. Infektsiya v kardiokhirurgii [Infection in cardiac surgery]. Moscow, NTsSSKh im. A.N. Bakuleva RAMN Publ., 2007, 572 p. (in Russian).
  16. Popov D.A. Postoperative infectious complications in cardiosurgery: the frequency of development, risk factors, etiology, peculiarities of pathogenesis, diagnosis optimization. Annaly khirurgii, 2011, no. 5, pp. 10–14 (in Russian).
  17. Yahav D., Schlesinger A., Daitch V., Akayzen Y., Farbman L., Abu-Ghanem Y., Paul M., Leibovici L. Presentation of infection in older patients – a prospective study. Ann. Med., 2015, vol. 47, no. 4, pp. 354–358. DOI: 10.3109/07853890.2015.1019915
  18. Hermandez C., Fehér C., Soriano A., Marco F., Almela M., Cobos-Trigueros N., De La Calle C., Morata L. [et al.]. Clinical characteristics and outcome of elderly patients with community-onset bacteremia. J. Infect., 2015, vol. 70, no. 2, pp. 135–143. DOI: 10.1016/j.jinf.2014.09.00
  19. Mladenovic J., Veljovic M., Udovicic I., Lazic S., Segrt Z., Ristic P., Suljagić V. Catheter-associated urinary tract infection in a surgical intensive care unit. Vojnosanit. Pregl., 2015, vol. 72, no. 10, pp. 883–888. DOI: 10.2298/vsp140624078m
  20. Priefer B.A., Duthie E.H. Jr., Gambert S.R. Frequency of urinary catheter change and clinical urinary tract infection. Study in hospital-based, skilled nursing home. Urology, 1982, vol. 20, no. 2, pp. 141–142. DOI: 10.1016/0090-4295(82)90343-0
  21. Firestein M., Mendelson G., Gronich D., Granot E., Ben-Israel J., Raz R. Can antibiotic use during routine replacement of long‐term urinary catheter prevent bacteriuria? Infectious Diseases in Clinical Practice, 2001, vol. 10, no. 3, pp. 133–135. DOI: 10.1097/00019048-200103000-00003
  22. Cheung K., Leung P., Wong Y., To O., Yeung Y., Chan M., Yip Y., Kwok C. Water versus antiseptic periurethral cleansing before catheterization among home care patients: a randomized controlled trial. Am. J. Infect. Control, 2008, vol. 36, no. 5, pp. 375–380. DOI: 10.1016/j.ajic.2007.03.004
  23. Lee M.H., Lee G.A., Lee S.H., Park Y.-H. Effectiveness and core components of infection prevention and control programmers in long-term care facilities: a systematic review. J. Hosp. Infect., 2019, vol. 102, no. 4, pp. 377–393. DOI: 10.1016/j.jhin.2019.02.008
  24. Markelova E.V., Yutskovskaya Ya.A., Birko O.N., Baibarina E.V., Chepurnova N.S. The immune system of the skin: the age peculiarities. Klinicheskaya dermatologiya i venerologiya, 2016, vol. 15, no. 6, pp. 4–10. DOI: 10.17116/klinderma20161564-10 (in Russian).
  25. Laube S. Skin infections and ageing. Ageing Res. Rev., 2004, vol. 3, no. 1, pp. 69–89. DOI: 10.1016/j.arr.2003.08.003
  26. Bazarnyi V.V. Immunnaya sistema kozhi [The immune system of the skin]. Mezoterapiya, 2014, no. 2, pp. 52–56 (in Russian).
  27. Kuznetsov S.V. Klinicheskaya gerontostomatologiya [Clinical gerontostomatology]. Moscow, MIA, 2018, 240 p.
  28. Petersen P.E., Yamamoto T. Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dent. Oral Epidemiol., 2005, vol. 33, no. 2, pp. 81–92. DOI: 10.1111/j.1600-0528.2004.00219.x
  29. Vissink A., Spijkervet F.K., Amerongen A.V.N. Aging and saliva: a review of the literature. Spec. Care Dentist., 1996, vol. 16, no. 3, pp. 95–103. DOI: 10.1111/j.1754-4505.1996.tb00842.x
  30. Griaznova O.S., Manuilskaya K.M. Housing-related needs assessment of older people in Russia and worldwide. Chelovek, 2020, vol. 31, no. 3, pp. 45–70. DOI: 10.31857/S023620070010036-6 (in Russian).
  31. Infection prevention and control manual for older people and adult care homes. National Services Scotland. Available at: (22.02.2022).
  32. Expósito Miralles S., Martínez Sánchez J., Munteanu Munteanu A.D., Caballer Miedes A. Evaluación diagnóstica del grado de adaptación de la ciudad de Castellón a las personas mayors. Àgora de Salut, 2017, vol. 4, pp. 93–98. DOI: 10.6035/AgoraSalut.2017.4.10
  33. Rogozin D.M. The British School of Social Gerontology: A Bibliographical Review of a Publication Project. Chelovek, 2020, no. 3, pp. 173–183. DOI: 10.31857/S023620070010041-2 (in Russian).
  34. Dickens A.P., Richards S.H., Greaves C.J., Campbell J.L. Interventions targeting social isolation in older people: a systematic review. BMC Public Health, 2011, vol. 11, pp. 647. DOI: 10.1186/1471-2458-11-647
  35. Polishchuk Yu.I., Baranskaya I.V., Gurvich V.B. Mediko-sotsial'naya pomoshch' litsam pozdnego vozrasta s reaktsiyami gorya i sostoyaniyami odinochestva [Medical and social assistance to elderly people with grief reactions and loneliness]. Gerontologiya i geriatriya, 2001, no. 1, pp. 312–315 (in Russian).
  36. Killick J. Communication and the care of people with dementia. UK, Open University Press, 2001, 338 p.
  37. Smol'kin A.A., Zhigareva P.A., Makarova E.A., Kiryukhina A.A., Milova E.A., Khaltourina D.A. Attitudes toward aging prevention: results of a focus groups study. Uspekhi gerontologii, 2017, vol. 30, no. 4, pp. 609–617 (in Russian).
  38. Bryzgalina E.P. Medicine in the optics of artificial intelligence: the philosophical context of the future. Chelovek, 2019, vol. 30, no. 6, pp. 54–71. DOI: 10.31857/S023620070007669-2 (in Russian).
  39. Cameron K. How Older Adults Can Stay Protected During the Omicron Surge. NCOA’s Center for Healthy Aging, 2022. Available at: (19.02.2022).
  40. Agapova E.G., Pritulina Yu.G., Donika A.D. Medical and sociological aspects of prevention of influenza and acute respiratory infections of aged people on the model group of military retirees. Zdorov'e i obrazovanie v 21 veke, 2017, vol. 19, no. 2, pp. 47–52 (in Russian).
  41. Reis J., Zaitseva N.V., Spencer P.S. Understanding the perception and hierarchy of risks: an environmental medico-scientific perspective with COVID-19 in mind. Health Risk Analysis, 2020, no. 3, pp. 5–18. DOI: 10.21668/health.risk/2020.3.01.eng
  42. Wiles J.L., Leibing A., Guberman N., Reeve J., Allen R.E. The meaning of “aging in place” to оlder people. Gerontologist, 2012, vol. 52, no. 3, pp. 357–366. DOI: 10.1093/geront/gnr098
  43. Morley J.E. Aging in place. J. Am. Med. Dir. Assoc., 2012, vol. 13, no. 6, pp. 489–492. DOI: 10.1016/j.jamda.2012.04.011
  44. Wagner S.L., Shubair M.M., Michalos A.C. Surveying Older Adults’ Opinions on Housing: Recommendations for Policy. Social Indicators Research, 2010, vol. 99, no. 3, pp. 405–412. DOI: 10.1007/s11205-010-9588-5
  45. World report on ageing and health. WHO, 2016. Available at: (15.12.2021).
  46. Popova A.Yu., Zaitseva N.V., Onishchenko G.G., Kleyn S.V., Glukhikh M.V., Kamaltdinov M.R. Sanitary-epidemiologic determinants and potential for growth in life expectancy of the population in the Russian Federation taking into account regional differentiation. Health Risk Analysis, 2020, no. 1, pp. 4–17. DOI: 10.21668/health.risk/2020.1.01.eng
  47. World Well-Being Project. Available at: (15.08.2021).
  48. Esposito S., Bonanni P., Maggi S., Tan L., Ansaldi F., Lopalco P.L., Dagan R., Michel J.-P. [et al.]. Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid). Hum. Vaccin. Immunother., 2016, vol. 12, no. 7, pp. 1777–1794. DOI: 10.1080/21645515.2016.1150396
  49. Tip Sheet: Home safety tips for older adults. AGS Health in Aging Foundation. Available at:
    Dproof%20your%20home,when%20you%20walk%20on%20them (22.02.2022).
  50. Iordanishvili A.K. Domestic prophylactic agents in maintaining the dental health of the elderly. Meditsinskii alfavit, 2020, no. 35, pp. 5–9. DOI: 10.33667/2078-5631-2020-35-5-9 (in Russian).
Accepted for publication: 

You are here