title: Low Hemoglobin Concentrations Are Associated With Sarcopenia, Physical Performance, and Disability in Older Australian Men in Cross-sectional and Longitudinal Analysis: The Concord Health and Ageing in Men Project.
abstract: The objective of this study is to examine associations between Hb levels and sarcopenia, low muscle strength, functional measures, and activities of daily living (ADL) and instrumental ADL (IADL) disabilities in older Australian men.
  
  
  
  Men aged 70 years and older (2005-2007) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 years (n = 1,367), and 5 years (n = 958). The main outcome measurements were walking speed, muscle strength, ADL and IADL disabilities, and sarcopenia using the Foundation for the National Institutes of Health criteria (low appendicular lean mass adjusted for body mass index < 0.789 and poor grip strength < 26kg). Analysis was performed using Hb levels as a continuous measure, unadjusted and adjusted by age, income, body mass index, measures of health, estimated glomerular function, inflammatory markers, and medication use. Receiver operating characteristic curve analysis was performed to determine a threshold of Hb for each outcome.
  
  
  
  In cross-sectional and longitudinal analysis, for every 1g/dL increase in Hb, there was a significant reduction in risk of sarcopenia, slow walking speed, poor grip strength, inability to perform chair stands, and ADL and IADL disabilities in unadjusted, age-adjusted, and multivariate-adjusted analysis. The highest value of the Youden Index for Hb was 14.2g/dL for sarcopenia and grip strength, 14.5g/dL for walking speed, and 14.4g/dL for all other outcomes.
  
  
  
  Declines in Hb levels over time are associated with poor functional outcomes. The risks and benefits of interventions to increase Hb among older men warrant further investigation to differentiate whether this is an active contributor to age-related debility or a passive biomarker of it.
authors.affiliation: School of Life and Environmental Sciences Charles Perkins Centre, vasant.hirani@sydney.edu.au.|Centre for Education and Research on Ageing, Concord Hospital.|The ARC Centre of Excellence in Population Ageing Research.
authors.forename: Vasant
authors.initials: V
authors.lastname: Hirani
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital.
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blyth
authors.affiliation: ANZAC Research Institute and Charles Perkins Centre.
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.affiliation: Bone Research Program, ANZAC Research Institute, Department of Endocrinology and Metabolism, Concord Hospital.
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Seibel
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Waite
authors.affiliation: Department of Andrology, ANZAC Research Institute, Concord Hospital, and.
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
authors.affiliation: Department of Andrology, ANZAC Research Institute, Concord Hospital, and.
authors.forename: Ben
authors.initials: B
authors.lastname: Hsu
authors.affiliation: Centre for Education and Research on Ageing, Concord Hospital.|The ARC Centre of Excellence in Population Ageing Research.|School of Public Health, University of Sydney, New South Wales, Australia.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001315:Australia; D003430:Cross-Sectional Studies; D003710:Demography; D015577:Geriatric Assessment; D018737:Hand Strength / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology*; D012307:Risk Factors; D055948:Sarcopenia / Q000097:blood* / Q000503:physiopathology*; D000072797:Walking Speed / Q000502:physiology
chemical_list: D006454:Hemoglobins
keywords: Disability; Functional outcomes; Hemoglobin; Older men; Sarcopenia