title: Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study.
abstract: Anemia represents a global health problem that negatively impacts quality of life in elderly population; however, its impact on the geriatric syndrome of frailty is unclear. We examined the prevalence of anemia among elderly and sought a relationship between hemoglobin and the phenotype of frailty. Baseline hemoglobin quintiles and anemia were assessed in relation to frailty status in a prospective study with 1,933 older community-dwelling adults enrolled in the Study on Aging and Dementia in Mexico (SADEM). Logistic regression was used to model the relationship between frailty and Hb, adjusting for risk factors of frailty, sociodemographic data, cognitive decline, chronic diseases, and some risky habits. Prevalence of frailty was 8.3 %. Frailty risk was highest at the lowest hemoglobin quintile (<14.3 g/dL for men; <13.3 g/dL for women), and 160 (8.3 %) were anemic (<13 g/dL for men; <12 g/dL for women). The relationship between frailty and Hb levels, adjusted for age and sex, observed in the first and fifth quintiles, compared with the fourth quintile, were 1.53 (95 % confidence interval (CI), 1.46-1.60) and 1.05 (95 % CI, 1.01-1.15). After multivariate adjustment, the odds ratios (ORs) were 1.23 (95 % CI, 1.17-1.13) and 1.06 (95 % CI, 1.01-1.11). The association was not diminished by risk factors for frailty (body mass index (BMI), comorbidity, cognitive decline, smoking, alcohol consumption, etc.). In community-dwelling older adults, low hemoglobin concentrations and anemia were independently associated with increased frailty risk. This suggests that mild anemia and low Hb levels are independent, modifiable risk factors for frailty.
authors.affiliation: Epidemiologic and Health Service Research Unit, Aging Area, Mexican Institute of Social Security, National Medical Center Century XXI, Edificio CORCE, Tercer piso, Avenida Cuauhtémoc no. 330, Col. Doctores, Delegación Cuauhtémoc, 06725, Mexico City, DF, Mexico, teresa.juarez@imss.gob.mx.
authors.forename: Teresa
authors.initials: T
authors.lastname: Juárez-Cedillo
authors.forename: Lourdes
authors.initials: L
authors.lastname: Basurto-Acevedo
authors.forename: Sara
authors.initials: S
authors.lastname: Vega-García
authors.forename: Leticia
authors.initials: L
authors.lastname: Manuel-Apolinar
authors.forename: Emiliano
authors.initials: E
authors.lastname: Cruz-Tesoro
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Rodríguez-Pérez
authors.forename: Normand
authors.initials: N
authors.lastname: García-Hernández
authors.forename: Nonanzit
authors.initials: N
authors.lastname: Pérez-Hernández
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Fragoso
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D000740:Anemia / Q000453:epidemiology*; D015992:Body Mass Index; D002908:Chronic Disease; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014505:Urban Population
chemical_list: D006454:Hemoglobins