Types of anemia and mortality among older disabled women living in the community: the Women's Health and Aging Study I.
OBJECTIVE
To classify the different types of anemia among moderately to severely disabled women living in the community and examine the relationship between types of anemia and mortality.


METHODS
We studied anemia in 688 women, >or=65 years, in the Women's Health and Aging Study I, a population based study of moderately to severely disabled older women living in the community in Baltimore, Maryland. Anemia was defined by World Health Organization criteria. Causes of anemia were classified as due to nutritional deficiencies (iron, folate, and B12 deficiencies), anemia of chronic inflammation, anemia with renal disease, and unexplained anemia.


RESULTS
147 of 688 (21.4%) women were anemic (hemoglobin <12 g/dL). Of the 147 anemic women, 22 (15.0%) had anemia due to nutritional causes, 45 (30.6%) had anemia due to chronic inflammation, 29 (19.7%) had anemia and renal disease, and 51 (34.7%) had unexplained anemia. The proportions of those who died over five years among non-anemic women and women with anemia due to nutritional causes, chronic inflammation, renal disease, and unexplained anemia were 26.1%, 18.2%, 38.6%, 64.3%, and 33.3%, respectively (p<0.0001). Compared with non-anemic women, those with anemia and renal disease (HR 1.99, 95% CI 1.18-3.35, p=0.009) and anemia of chronic inflammation (HR 1.69, 95% CI 1.00-2.84, p=0.05) had higher risk of death.


CONCLUSIONS
Anemia is common among moderately to severely disabled older women living in the community, and about one-third of the anemia is unexplained. Anemia with renal disease and anemia of chronic inflammation are associated with a higher mortality.
Semba
Richard D
RD
The Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA. rdsemba@jhmi.edu
Ricks
Michelle O
MO
Ferrucci
Luigi
L
Xue
Qian-Li
QL
Chaves
Paulo
P
Fried
Linda P
LP
Guralnik
Jack M
JM
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality*; D002908:Chronic Disease; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000401:mortality; D007674:Kidney Diseases / Q000150:complications / Q000401:mortality; D044342:Malnutrition / Q000150:complications / Q000401:mortality; D009749:Nutrition Surveys; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D014481:United States / Q000453:epidemiology