Association of mild anemia with cognitive, functional, mood and quality of life outcomes in the elderly: the "Health and Anemia" study.
BACKGROUND
In the elderly persons, hemoglobin concentrations slightly below the lower limit of normal are common, but scant evidence is available on their relationship with significant health indicators. The objective of the present study was to cross-sectionally investigate the association of mild grade anemia with cognitive, functional, mood, and quality of life (QoL) variables in community-dwelling elderly persons.


METHODS
Among the 4,068 eligible individuals aged 65-84 years, all persons with mild anemia (n = 170) and a randomly selected sample of non-anemic controls (n = 547) were included in the study. Anemia was defined according to World Health Organization (WHO) criteria and mild grade anemia was defined as a hemoglobin concentration between 10.0 and 11.9 g/dL in women and between 10.0 and 12.9 g/dL in men. Cognition and functional status were assessed using measures of selective attention, episodic memory, cognitive flexibility and instrumental and basic activities of daily living. Mood and QoL were evaluated by means of the Geriatric Depression Scale-10, the Short-Form health survey (SF-12), and the Functional Assessment of Cancer Therapy-Anemia.


RESULTS
In univariate analyses, mild anemic elderly persons had significantly worse results on almost all cognitive, functional, mood, and QoL measures. In multivariable logistic regressions, after adjustment for a large number of demographic and clinical confounders, mild anemia remained significantly associated with measures of selective attention and disease-specific QoL (all fully adjusted p<.046). When the lower limit of normal hemoglobin concentration according to WHO criteria was raised to define anemia (+0.2 g/dL), differences between mild anemic and non anemic elderly persons tended to increase on almost every variable.


CONCLUSIONS
Cross-sectionally, mild grade anemia was independently associated with worse selective attention performance and disease-specific QoL ratings.
Lucca
Ugo
U
Laboratory of Geriatric Neuropsychiatry, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy. lucca@marionegri.it
Tettamanti
Mauro
M
Mosconi
Paola
P
Apolone
Giovanni
G
Gandini
Francesca
F
Nobili
Alessandro
A
Tallone
Maria Vittoria
MV
Detoma
Paolo
P
Giacomin
Adriano
A
Clerico
Mario
M
Tempia
Patrizia
P
Guala
Adriano
A
Fasolo
Gilberto
G
Riva
Emma
E
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000740:Anemia / Q000150:complications*; D016022:Case-Control Studies; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications*; D015897:Comorbidity; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008568:Memory; D011788:Quality of Life