David P. Steensma, MD, FACP
What is the association between anemia and mortality in very old persons?
Population-based cohort study (Leiden 85-plus study) with annual follow-up for 5 years.
Leiden, The Netherlands.
562 inhabitants of Leiden who were 85 years of age (34% men).
Anemia (hemoglobin level < 120 g/L for women and < 130 g/L for men), defined as prevalent (present at baseline [85 y]) and incident (newly identified after age 85 y in those without anemia at baseline); comorbid conditions, defined as known disease, (stroke, myocardial infarction, severe cognitive impairment, diabetes mellitus, Parkinson disease, hip fracture, arthritis, obstructive lung disease, and malignant disease) and undiagnosed disease (C-reactive protein level and creatinine clearance); and sex, education, income, and residence in long-term care.
Participants with prevalent anemia at baseline (27%) had an increased risk for death compared with those without anemia at baseline (Table). A dose–response relation was found between severity of anemia and mortality (P for trend < 0.01) (Table). Among the 412 participants without anemia at baseline, 24% developed incident anemia; risk for death was increased 2-fold compared with those who did not develop anemia (Table).
In very old persons, anemia was associated with an increased risk for death, independent of comorbid conditions.
Association between anemia and mortality in very old persons*
*CI defined in Glossary.
†Adjusted for sex, education level, income, residence in long-term care, ≥ 1 known disease, C-reactive protein level, and creatinine clearance at baseline.
‡Mild = hemoglobin 110 to 119 g/L for women, 120 to 129 g/L for men; moderate = 100 to 109 g/L for women, 110 to 119 g/L for men; severe = < 100 g/L for women, < 110 g/L for men. All compared with no anemia (reference 1.00).
§Of 412 participants without anemia at baseline.
Steensma DP. Anemia was independently associated with mortality in very old persons. Ann Intern Med. ;151:JC6–13. doi: 10.7326/0003-4819-151-12-200912150-02013
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Published: Ann Intern Med. 2009;151(12):JC6-13.
Hematology/Oncology, Red Cell Disorders.
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