title: Association between mild anemia and executive function impairment in community-dwelling older women: The Women's Health and Aging Study II.
abstract: OBJECTIVE
  To evaluate the relationship between mild anemia and executive function in community-dwelling older women.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Community-based.
  
  
  METHODS
  High-functioning subjects participating in the baseline assessment of the Women's Health and Aging Study (WHAS) II, Baltimore, Maryland, 1994 to 1996. WHAS II eligibility criteria included aged 70 to 80, a Mini-Mental State Examination score of 24 or greater, and absence of advanced disability (difficulty in no more than 1 domain of physical function). Included in this study were 364 subjects with a hemoglobin concentration 10 g/dL or greater and known executive function status.
  
  
  METHODS
  Trail Making Test (TMT) Parts B and A. Tertiles of time to complete each test were used to define best (bottom), intermediate, and worst (top) performance. Tertiles of the difference TMT-B minus TMT-A were calculated. Anemia defined as hemoglobin concentration less than 12 g/dL.
  
  
  RESULTS
  The percentage of subjects in the worst TMT-B, TMT-A, and TMT-B minus TMT-A performance tertile was highest for those with anemia. Prevalent anemia substantially increased the likelihood of performing worst (as opposed to best) on the TMT-B (odds ratio (OR) = 5.2, 95% confidence interval (CI) = 1.3-20.5), TMT-A (OR = 4.8, 95% CI = 1.5-15.6), and TMT-B minus TMT-A (OR = 4.2, 95% CI = 1.0-17.2), even after controlling for age, education, race, prevalent diseases, and relevant physiological and functional parameters.
  
  
  CONCLUSIONS
  This study provides preliminary evidence in support of the hypothesis that mild anemia might be an independent risk factor for executive function impairment in community-dwelling older adults. Whether such an association is causal or noncausal remains to be determined.
authors.affiliation: Center on Aging and Health and Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA. pchaves@jhsph.edu
authors.forename: Paulo H M
authors.initials: PH
authors.lastname: Chaves
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Carlson
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Richard
authors.initials: R
authors.lastname: Semba
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000523:psychology*; D003072:Cognition Disorders / Q000097:blood / Q000209:etiology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006304:Health Status; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D012111:Residence Characteristics; D014145:Trail Making Test
chemical_list: D006454:Hemoglobins