Anemia is associated with disability and decreased physical performance and muscle strength in the elderly.
OBJECTIVE
To examine the association between anemia and disability, physical performance, and muscle strength in older persons.


METHODS
Cross-sectional.


METHODS
Community-dwelling older persons in the Chianti area in Italy.


METHODS
A total of 1,156 persons aged 65 and older participating in the InChianti Study ("Invecchiare in Chianti," i.e., Aging in the Chianti Area).


METHODS
Anemia was defined according to World Health Organization criteria as a hemoglobin concentration below 12 g/dL in women and below 13 g/dL in men. Disability in six basic and eight instrumental activities of daily living was assessed. Physical performance was assessed using the short physical performance battery (4-m walk, balance, and chair stands), which yields a summary performance score ranging from 0 to 12 (high). Muscle strength was determined using knee extensor and handgrip strength assessments.


RESULTS
Overall, 11.1% of the men and 11.5% of the women had anemia. After adjustment for age, sex, body mass index, Mini-Mental State Examination score, creatinine level, and presence of various comorbid conditions, anemic persons had more disabilities (1.71 vs 1.04, P=.002) and poorer performance (8.8 vs 9.6, P=.003) than persons without anemia. Anemic persons also had significantly lower knee extensor strength (14.1 vs 15.2 kg, P=.02) and lower handgrip strength (25.3 vs 27.1 kg, P=.04) than persons without anemia. Further adjustment for inflammatory markers (interleukin-6, C-reactive protein, tumor necrosis factor-alpha) did not change these associations.


CONCLUSIONS
Anemia is associated with disability, poorer physical performance, and lower muscle strength. Further research should explore whether treating anemia has a beneficial effect on the functional status of older persons.
Penninx
Brenda W J H
BW
Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. Brendap@ggzba.nl
Pahor
Marco
M
Cesari
Matteo
M
Corsi
Anna Maria
AM
Woodman
Richard C
RC
Bandinelli
Stephania
S
Guralnik
Jack M
JM
Ferrucci
Luigi
L
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000175:diagnosis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D006233:Persons with Disabilities; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D009043:Motor Activity; D018482:Muscle, Skeletal / Q000502:physiology*; D010809:Physical Fitness; D012737:Sex Factors; D014944:World Health Organization
D006454:Hemoglobins