Five-year survival of older people with anemia: variation with hemoglobin concentration.
OBJECTIVE
To investigate the significance of low hemoglobin concentration and longevity in older people.


METHODS
Randomized prospective study.


METHODS
Nursing home and geriatric hospital ward in a metropolitan welfare center.


METHODS
Apparently stable older residents from 1990 to 1996.


METHODS
Survival rates were estimated by statistical analysis. Sixty-three older subjects with low hemoglobin (Hb<11 g/dl) and age/sex-matched normal controls (Hb> or =11 g/dl) were observed for 60 months. Scores of activities of daily living (ADLs) did not significantly differ between the two groups. Cerebrovascular disease was the main complication in both, and malignant neoplasms were not apparent initially.


RESULTS
After 60 months, the 5-year survival rate (FSR) of normal controls was significantly higher than that of cases with anemia (P =.0078). FSR was 67% in normal controls and 48% in anemic individuals age 70 to 79. The figures for individuals age 80 to 89 were 62% and 41%, respectively, and for individuals age 90 to 99 were 25% and 13%, respectively, the survival rate significantly decreasing with age in both groups (P <.001). FSR with severe anemia (Hb< or = 8.9 g/dl) was 0% in males, and 27% in females. Values for moderate anemia (9.0 g/dl to 10.9 g/dl) were 25% and 51%, respectively, for normal hemoglobin (11.0 g/dl to 12.9 g/dl) were 44% and 61%, respectively, and for high hemoglobin (13.0 g/dl< or =Hb) were 50% and 70%, respectively. Advanced carcinomas were often detected at autopsy in anemic individuals. No death by cancer occurred in normal controls.


CONCLUSIONS
Low hemoglobin concentration predicts early death in nursing home residents. Anemia-associated conditions that might be life-threatening risks in older people require further investigation.
Kikuchi
M
M
Second Department of Internal Medicine, Nagoya City University Medical School, Nagoya City, Japan.
Inagaki
T
T
Shinagawa
N
N
D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000401:mortality*; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D006454:Hemoglobins; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009735:Nursing Homes; D011446:Prospective Studies; D015996:Survival Rate
D006454:Hemoglobins