BACKGROUND: Anemia is viewed as a negative prognostic factor in the elderly population; its independent impact on survival is unclear. METHODS: Baseline hemoglobin quintiles and anemia, as defined by the World Health Organization criteria, were assessed in relation to mortality in the Cardiovascular Health Study, a prospective cohort study with 11.2 years of follow-up of 5888 community-dwelling men and women 65 years or older, enrolled in 1989-1990 or 1992-1993 in 4 US communities. RESULTS: A total of 1205 participants were in the lowest hemoglobin quintile (<13.7 g/dL for men; <12.6 g/dL for women), and 498 (8.5%) were anemic (<13 g/dL for men; <12 g/dL for women). A reverse J-shaped relationship with mortality was observed; age-, sex-, and race-adjusted hazard ratios (95% confidence interval [CI]) in the first and fifth quintiles, compared with the fourth quintile, were 1.42 (95% CI, 1.25-1.62) and 1.24 (95% CI, 1.09-1.42). After multivariate adjustment, these hazard ratios were 1.33 (95% CI, 1.15-1.54) and 1.17 (95% CI, 1.01-1.36). The demographic- and fully-adjusted hazard ratios of anemia for mortality were 1.57 (95% CI, 1.38-1.78) and 1.38 (95% CI, 1.19-1.54). Adjustment for causes and consequences of anemia (renal function, inflammation, or frailty) did not reduce associations. CONCLUSIONS: Lower and higher hemoglobin concentrations and anemia by World Health Organization criteria were independently associated with increased mortality. The World Health Organization criteria did not identify risk as well as a lower hemoglobin value. Additional study is needed on the clinically valid definition for and causes of anemia in the elderly and on the increased mortality at the extremes of hemoglobin concentrations.
BACKGROUND:Anemia is viewed as a negative prognostic factor in the elderly population; its independent impact on survival is unclear. METHODS: Baseline hemoglobin quintiles and anemia, as defined by the World Health Organization criteria, were assessed in relation to mortality in the Cardiovascular Health Study, a prospective cohort study with 11.2 years of follow-up of 5888 community-dwelling men and women 65 years or older, enrolled in 1989-1990 or 1992-1993 in 4 US communities. RESULTS: A total of 1205 participants were in the lowest hemoglobin quintile (<13.7 g/dL for men; <12.6 g/dL for women), and 498 (8.5%) were anemic (<13 g/dL for men; <12 g/dL for women). A reverse J-shaped relationship with mortality was observed; age-, sex-, and race-adjusted hazard ratios (95% confidence interval [CI]) in the first and fifth quintiles, compared with the fourth quintile, were 1.42 (95% CI, 1.25-1.62) and 1.24 (95% CI, 1.09-1.42). After multivariate adjustment, these hazard ratios were 1.33 (95% CI, 1.15-1.54) and 1.17 (95% CI, 1.01-1.36). The demographic- and fully-adjusted hazard ratios of anemia for mortality were 1.57 (95% CI, 1.38-1.78) and 1.38 (95% CI, 1.19-1.54). Adjustment for causes and consequences of anemia (renal function, inflammation, or frailty) did not reduce associations. CONCLUSIONS: Lower and higher hemoglobin concentrations and anemia by World Health Organization criteria were independently associated with increased mortality. The World Health Organization criteria did not identify risk as well as a lower hemoglobin value. Additional study is needed on the clinically valid definition for and causes of anemia in the elderly and on the increased mortality at the extremes of hemoglobin concentrations.
Authors: Mauro Tettamanti; Ugo Lucca; Francesca Gandini; Angela Recchia; Paola Mosconi; Giovanni Apolone; Alessandro Nobili; Maria Vittoria Tallone; Paolo Detoma; Adriano Giacomin; Mario Clerico; Patrizia Tempia; Luigi Savoia; Gilberto Fasolo; Luisa Ponchio; Matteo G Della Porta; Emma Riva Journal: Haematologica Date: 2010-06-09 Impact factor: 9.941
Authors: Bryan J McCranor; Jacqueline M Langdon; Olivier D Prince; Laurette K Femnou; Alan E Berger; Chris Cheadle; Curt I Civin; Airie Kim; Seth Rivera; Tomas Ganz; Sophie Vaulont; Qian-Li Xue; Jeremy D Walston; Cindy N Roy Journal: Haematologica Date: 2013-08-30 Impact factor: 9.941
Authors: Christina L Bell; Randi Chen; Kamal Masaki; Priscilla Yee; Qimei He; John Grove; Timothy Donlon; J David Curb; D Craig Willcox; Leonard W Poon; Bradley J Willcox Journal: J Am Geriatr Soc Date: 2014-04-29 Impact factor: 5.562
Authors: Marco Inzitari; Stephanie Studenski; Caterina Rosano; Neil A Zakai; William T Longstreth; Mary Cushman; Anne B Newman Journal: J Am Geriatr Soc Date: 2008-09-22 Impact factor: 5.562