Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study

Abstract

Anemia represents a global health problem that negatively impacts quality of life in elderly population; however, its impact on the geriatric syndrome of frailty is unclear. We examined the prevalence of anemia among elderly and sought a relationship between hemoglobin and the phenotype of frailty. Baseline hemoglobin quintiles and anemia were assessed in relation to frailty status in a prospective study with 1,933 older community-dwelling adults enrolled in the Study on Aging and Dementia in Mexico (SADEM). Logistic regression was used to model the relationship between frailty and Hb, adjusting for risk factors of frailty, sociodemographic data, cognitive decline, chronic diseases, and some risky habits. Prevalence of frailty was 8.3 %. Frailty risk was highest at the lowest hemoglobin quintile (<14.3 g/dL for men; <13.3 g/dL for women), and 160 (8.3 %) were anemic (<13 g/dL for men; <12 g/dL for women). The relationship between frailty and Hb levels, adjusted for age and sex, observed in the first and fifth quintiles, compared with the fourth quintile, were 1.53 (95 % confidence interval (CI), 1.46-1.60) and 1.05 (95 % CI, 1.01-1.15). After multivariate adjustment, the odds ratios (ORs) were 1.23 (95 % CI, 1.17-1.13) and 1.06 (95 % CI, 1.01-1.11). The association was not diminished by risk factors for frailty (body mass index (BMI), comorbidity, cognitive decline, smoking, alcohol consumption, etc.). In community-dwelling older adults, low hemoglobin concentrations and anemia were independently associated with increased frailty risk. This suggests that mild anemia and low Hb levels are independent, modifiable risk factors for frailty.

Distinct Physical Function Profiles in Older Adults Receiving Cancer Chemotherapy

“…56 Using this definition, not unexpectedly in patients undergoing CTX, all three classes of older patients were anemic. This problem is important to evaluate in older adults because anemia is associated with decreased physical performance, 57 an increase in the number of falls, 58 frailty, 57,59,60 increase in depressive symptoms, 61,62 increase in the number of hospitalizations, 63 and increased mortality. 64,65 While the level of anemia observed in this study may not warrant routine treatment in oncology patients, clinicians need to monitor older adults receiving CTX more carefully to evaluate the impact of anemia on their ability to function.…”

Erythropoiesis-stimulating agents in elderly patients with anemia: response and cardiovascular outcomes

“…[1][2][3][4] A specific cause cannot be found in approximately 37% to 45% of cases of anemia in the elderly, despite investigations in search of an etiology. [5][6][7] The terms "anemia of unknown etiology" (AUE) and "unexplained anemia in the elderly" are used to describe this population of patients with unexplained or senile anemia.…”

Chronic kidney disease‐related physical frailty and cognitive impairment: a systemic review

“…Frailty was significantly associated with the use of vitamin D (r = 0.16; p = 0.03), hemoglobin (r = ‐0.14; p = ‐ 0.02) and intact parathyroid hormone (r = 0.16; p = 0.03) . Anemia was associated with frailty in both cross‐sectional and longitudinal analyses, and anemia precedes frailty in men who were nonfrail at baseline, which indicated that anemia was independently associated with an increased risk of frailty . This may be explained by the hypothesis that anemia produces fatigue and reduces muscular oxygenation, which can affect muscular strength and quality and, later, physical performance …”

“…74 Anemia was associated with frailty in both cross-sectional and longitudinal analyses, and anemia precedes frailty in men who were nonfrail at baseline, which indicated that anemia was independently associated with an increased risk of frailty. 75,76 This may be explained by the hypothesis that anemia produces fatigue and reduces muscular oxygenation, which can affect muscular strength and quality and, later, physical performance. 77 Sleep disordered breathing (SDB) is common among chronic kidney disease (CKD) patients and is a risk factor for cognitive dysfunction in the general population.…”