title: The prevalence, correlates and impact of anaemia among older people in Cuba, Dominican Republic, Mexico, Puerto Rico and Venezuela.
abstract: Anaemia among older people is increasingly recognized as a matter of public health concern. Data from low- and middle-income countries are sparse. We surveyed 10915 people aged 65 years and over (8423 with blood tests) in catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela and Mexico, to assess prevalence and correlates of anaemia and impact on disability. Prevalence varied widely between sites, from 6·4% in rural Mexico to 9·2% in urban Mexico, 9·8% in Venezuela, 19·2% in Cuba, 32·1% in Puerto Rico and 37·3% in Dominican Republic. Prevalence was higher in men and increased with age, but sociodemographic composition did not account for prevalence differences between sites. Standardized morbidity ratios indicated a much higher prevalence in Cuba (173), Puerto Rico (280) and Dominican Republic (332) compared with USA National Health and National Examination Surveys. Anaemia was associated with undernutrition, physical impairments, and serum creatinine. There was an association with greater African admixture in Dominican Republic but not in Cuba. African admixture is therefore unlikely to fully explain the high prevalence in the Caribbean islands, which may also arise from environmental, possibly dietary factors. Given an important independent contribution of anaemia to disability, more research is needed to identify preventable and treatable causes.
authors.affiliation: Health Service and Population Research Department, King's College London, London, UK.
authors.forename: Renata M
authors.initials: RM
authors.lastname: Bryce
authors.forename: Aquiles
authors.initials: A
authors.lastname: Salas
authors.forename: Daisy
authors.initials: D
authors.lastname: Acosta
authors.forename: Ivonne Z
authors.initials: IZ
authors.lastname: Jimenez-Velazquez
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Llibre-Rodriguez
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Sosa
authors.forename: Beatriz Marcheco
authors.initials: BM
authors.lastname: Teruel
authors.forename: Adolfo
authors.initials: A
authors.lastname: Valhuerdi
authors.forename: Cleusa P
authors.initials: CP
authors.lastname: Ferri
authors.forename: Paul
authors.initials: P
authors.lastname: McKeigue
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Prince
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology*; D003462:Cuba / Q000453:epidemiology; D003906:Developing Countries; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D014687:Venezuela / Q000453:epidemiology