title: Low hemoglobin levels and recurrent falls in U.S. men and women: prospective findings from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.
abstract: BACKGROUND
  There are few data available on low hemoglobin and incident falls in the general U.S. population.
  
  
  METHODS
  Of 30,239 black and white U.S. adults ≥45 years in the population-based REasons for Geographic And Racial Differences in Stroke study, 16,782 had hemoglobin measured at baseline and follow-up data on falls. Hemoglobin was categorized by 1.0 g/dL increments relative to the World Health Organization anemia threshold (<13.0 g/dL for men, <12.0 g/dL for women). Recurrent falls (≥2 falls in the 6 months after baseline) were assessed during a telephone interview.
  
  
  RESULTS
  Recurrent falls occurred in 3.9% of men and 4.8% of women. Compared with those with a hemoglobin level 1 to 2 g/dL above the anemia cut-off, multivariable adjusted odds ratios (95% confidence intervals) for recurrent falls associated with hemoglobin levels ≥3, 2 to <3 and 0 to 1 g/dL above the cut-off point, and 0 to <1 and ≥1 g/dL below the cut-off point were 0.73 (0.45-1.19), 0.84 (0.57-1.24), 1.29 (0.88-1.90), 1.32 (0.0.80-1.2.18) and 2.12 (1.23-3.63), respectively, among men (linear trend P < 0.001), and 1.59 (1.10-2.3), 1.24 (0.95-1.62), 1.42(1.11-1.81), 1.28 (0.91-1.80) and 1.76 (1.13-2.74), respectively, among women (linear trend P = 0.45; quadratic trend P = 0.016).
  
  
  CONCLUSIONS
  Among men, lower hemoglobin levels were associated with an increased risk for recurrent falls. Although our findings suggest an increased risk for recurrent falls at both lower and higher hemoglobin levels among women, these findings should be confirmed in subsequent studies.
authors: Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama 35233, USA. bbowling@uab.edu
authors: C Barrett
authors: CB
authors: Bowling
authors: Paul
authors: P
authors: Muntner
authors: Brian D
authors: BD
authors: Bradbury
authors: Ryan D
authors: RD
authors: Kilpatrick
authors: John J
authors: JJ
authors: Isitt
authors: Amy H
authors: AH
authors: Warriner
authors: Jeffrey R
authors: JR
authors: Curtis
authors: Suzanne
authors: S
authors: Judd
authors: Cynthia J
authors: CJ
authors: Brown
authors: Richard M
authors: RM
authors: Allman
authors: David G
authors: DG
authors: Warnock
authors: William
authors: W
authors: McClellan
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000740:Anemia / Q000097:blood / Q000150:complications*; D044383:Black People; D015331:Cohort Studies; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke; D014481:United States; D044465:White People; D001741:Black or African American
chemical_list: D006454:Hemoglobins