title: Association of mild anemia with hospitalization and mortality in the elderly: the Health and Anemia population-based study.
abstract: BACKGROUND
  Mild anemia is a frequent laboratory finding in the elderly usually disregarded in everyday practice as an innocent bystander. The aim of the present population-based study was to prospectively investigate the association of mild grade anemia with hospitalization and mortality.
  
  
  METHODS
  A prospective population-based study of all 65 to 84 year old residents in Biella, Italy was performed between 2003 and 2007. Data from a total of 7,536 elderly with blood tests were available to estimate mortality; full health information available to evaluate health-related outcomes was available for 4,501 of these elderly subjects. 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.
  
  
  RESULTS
  The risk of hospitalization in the 3 years following recruitment was higher among the mildly anemic elderly subjects than among subjects who were not anemic (adjusted hazard ratio: 1.32; 95% confidence interval: 1.09-1.60). Mortality risk in the following 3.5 years was also higher among the mildly anemic elderly (adjusted hazard ratio: 1.86; 95% confidence interval: 1.34-2.53). Similar results were found when slightly elevating the lower limit of normal hemoglobin concentration to 12.2 g/dL in women and to 13.2 g/dL in men. The risk of mortality was significantly increased in mild anemia of chronic disease but not in that due to beta-thalassemia minor.
  
  
  CONCLUSIONS
  After controlling for many potential confounders, mild grade anemia was found to be prospectively associated with clinically relevant outcomes such as increased risk of hospitalization and all-cause mortality. Whether raising hemoglobin concentrations can reduce the risks associated with mild anemia should be tested in controlled clinical trials.
authors.affiliation: Laboratory of Geriatric Neuropsychiatry, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
authors.forename: Emma
authors.initials: E
authors.lastname: Riva
authors.forename: Mauro
authors.initials: M
authors.lastname: Tettamanti
authors.forename: Paola
authors.initials: P
authors.lastname: Mosconi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Apolone
authors.forename: Francesca
authors.initials: F
authors.lastname: Gandini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
authors.forename: Maria Vittoria
authors.initials: MV
authors.lastname: Tallone
authors.forename: Paolo
authors.initials: P
authors.lastname: Detoma
authors.forename: Adriano
authors.initials: A
authors.lastname: Giacomin
authors.forename: Mario
authors.initials: M
authors.lastname: Clerico
authors.forename: Patrizia
authors.initials: P
authors.lastname: Tempia
authors.forename: Adriano
authors.initials: A
authors.lastname: Guala
authors.forename: Gilberto
authors.initials: G
authors.lastname: Fasolo
authors.forename: Ugo
authors.initials: U
authors.lastname: Lucca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006262:Health; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D013997:Time Factors