Anemia and cognitive performance in hospitalized older patients: results from the GIFA study.
BACKGROUND
Anemia represents a major risk factor for adverse health-related events in older persons. The aim of this study was to evaluate the association between hemoglobin levels/anemia and cognitive function in hospitalized older persons.


METHODS
Data are from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study. Hemoglobin levels (in g/dL) were measured upon admission to hospital; anemia was defined according to the WHO criteria. Cognitive performance was assessed by the Abbreviated Mental Test (AMT) on admission; an AMT score <7 defined cognitive impairment. Logistic regressions and analyses of covariance were performed to evaluate the relationship between cognitive status and hemoglobin levels/anemia.


RESULTS
Mean age of the sample (n = 13,301) was 72.0 years. Participants with cognitive impairment presented a higher prevalence of anemia (47%) compared to those without cognitive impairment (35%, p < 0.001). Adjusted logistic regressions showed that hemoglobin levels/anemia were significantly associated with cognitive impairment (OR = 0.96, 95%CI = 0.94-0.99, p = 0.004, and OR = 1.32, 95%CI = 1.18-1.48, p < 0.001, respectively). Patients with anemia and cognitive impairment at the hospital admission presented a higher number of impaired Activities of Daily Living compared to those with only one or none of the studied conditions (p for trend < 0.001).


CONCLUSIONS
Low hemoglobin levels and anemia are independently associated with cognitive performance in older persons admitted to acute care units.
Zamboni
Valentina
V
Department of Gerontology, Geriatrics and Physiatry, Catholic University of Sacred Heart, Rome, Italy. valentina_zamboni@rm.unicatt.it
Cesari
Matteo
M
Zuccalà
Giuseppe
G
Onder
Graziano
G
Woodman
Richard C
RC
Maraldi
Cinzia
C
Ranzini
Monica
M
Volpato
Stefano
S
Pahor
Marco
M
Bernabei
Roberto
R
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology*; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests
D006454:Hemoglobins