Vasant Hirani1,2,3, Vasi Naganathan2, Fiona Blyth2, David G Le Couteur4, Markus J Seibel5, Louise M Waite2, David J Handelsman6, Ben Hsu6, Robert G Cumming2,3,7. 1. School of Life and Environmental Sciences Charles Perkins Centre, vasant.hirani@sydney.edu.au. 2. Centre for Education and Research on Ageing, Concord Hospital. 3. The ARC Centre of Excellence in Population Ageing Research. 4. ANZAC Research Institute and Charles Perkins Centre. 5. Bone Research Program, ANZAC Research Institute, Department of Endocrinology and Metabolism, Concord Hospital. 6. Department of Andrology, ANZAC Research Institute, Concord Hospital, and. 7. School of Public Health, University of Sydney, New South Wales, Australia.
Abstract
BACKGROUND: The objective of this study is to examine associations between Hb levels and sarcopenia, low muscle strength, functional measures, and activities of daily living (ADL) and instrumental ADL (IADL) disabilities in older Australian men. METHODS: Men aged 70 years and older (2005-2007) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 years (n = 1,367), and 5 years (n = 958). The main outcome measurements were walking speed, muscle strength, ADL and IADL disabilities, and sarcopenia using the Foundation for the National Institutes of Health criteria (low appendicular lean mass adjusted for body mass index < 0.789 and poor grip strength < 26kg). Analysis was performed using Hb levels as a continuous measure, unadjusted and adjusted by age, income, body mass index, measures of health, estimated glomerular function, inflammatory markers, and medication use. Receiver operating characteristic curve analysis was performed to determine a threshold of Hb for each outcome. RESULTS: In cross-sectional and longitudinal analysis, for every 1g/dL increase in Hb, there was a significant reduction in risk of sarcopenia, slow walking speed, poor grip strength, inability to perform chair stands, and ADL and IADL disabilities in unadjusted, age-adjusted, and multivariate-adjusted analysis. The highest value of the Youden Index for Hb was 14.2g/dL for sarcopenia and grip strength, 14.5g/dL for walking speed, and 14.4g/dL for all other outcomes. CONCLUSION: Declines in Hb levels over time are associated with poor functional outcomes. The risks and benefits of interventions to increase Hb among older men warrant further investigation to differentiate whether this is an active contributor to age-related debility or a passive biomarker of it.
BACKGROUND: The objective of this study is to examine associations between Hb levels and sarcopenia, low muscle strength, functional measures, and activities of daily living (ADL) and instrumental ADL (IADL) disabilities in older Australian men. METHODS:Men aged 70 years and older (2005-2007) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 years (n = 1,367), and 5 years (n = 958). The main outcome measurements were walking speed, muscle strength, ADL and IADL disabilities, and sarcopenia using the Foundation for the National Institutes of Health criteria (low appendicular lean mass adjusted for body mass index < 0.789 and poor grip strength < 26kg). Analysis was performed using Hb levels as a continuous measure, unadjusted and adjusted by age, income, body mass index, measures of health, estimated glomerular function, inflammatory markers, and medication use. Receiver operating characteristic curve analysis was performed to determine a threshold of Hb for each outcome. RESULTS: In cross-sectional and longitudinal analysis, for every 1g/dL increase in Hb, there was a significant reduction in risk of sarcopenia, slow walking speed, poor grip strength, inability to perform chair stands, and ADL and IADL disabilities in unadjusted, age-adjusted, and multivariate-adjusted analysis. The highest value of the Youden Index for Hb was 14.2g/dL for sarcopenia and grip strength, 14.5g/dL for walking speed, and 14.4g/dL for all other outcomes. CONCLUSION: Declines in Hb levels over time are associated with poor functional outcomes. The risks and benefits of interventions to increase Hb among older men warrant further investigation to differentiate whether this is an active contributor to age-related debility or a passive biomarker of it.
Authors: Shajjia Razi; Victoria C Cogger; Marina Kennerson; Vicky L Benson; Aisling C McMahon; Fiona M Blyth; David J Handelsman; Markus J Seibel; Vasant Hirani; Vasikaran Naganathan; Louise Waite; Rafael de Cabo; Robert G Cumming; David G Le Couteur Journal: J Gerontol A Biol Sci Med Sci Date: 2017-07-01 Impact factor: 6.053
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