Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Aug 4;181(3-4):151-7.
doi: 10.1503/cmaj.090040. Epub 2009 Jul 27.

Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85-plus Study

Wendy P J den Elzen  1 , Jorien M Willems, Rudi G J Westendorp, Anton J M de Craen, Willem J J Assendelft, Jacobijn Gussekloo
Affiliations

Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85-plus Study

Wendy P J den Elzen et al. CMAJ. .

Abstract

Background: There is limited insight into the attributable effect of anemia and comorbidity on functional status and mortality in old age.

Methods: The Leiden 85-plus Study is a population-based prospective follow-up study of 562 people aged 85 years. Anemia was defined according to World Health Organization criteria. We measured 3 parameters of functional status at baseline and annually thereafter for 5 years: disability in basic and instrumental activities of daily living, cognitive function and the presence of depressive symptoms. We obtained mortality data from the municipal registry.

Results: The prevalence of anemia at baseline was 26.7% (150/562). Participants who had anemia at baseline had more disability in activities of daily living, worse cognitive function and more depressive symptoms than participants without anemia at baseline (p <or= 0.01). These differences disappeared after adjustment for comorbidity. After adjustment for comorbidity in the prospective analyses, anemia at baseline was associated with an additional increase in disability in instrumental activities of daily living during follow-up; incident anemia during follow-up (n = 99) was associated with an additional increase in disability in basic activities of daily living. Prevalent and incident anemia were both associated with an increased risk of death, even after we adjusted for sex, education level, income, residence in a long-term care facility, C-reactive protein level, creatinine clearance and the presence of disease (hazard ratio for prevalent anemia 1.41, 95% confidence interval [CI] 1.13 to 1.76; hazard ratio for incident anemia 2.08, 95% CI 1.60 to 2.70).

Interpretation: Anemia in very elderly people appears to be associated with an increased risk of death, independent of comorbidity. However, the associated functional decline appears to be attributed mainly to comorbidity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Number of participants at the outset of the study and annually thereafter for 5 years.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Izaks GJ, Westendorp RG, Knook DL. The definition of anemia in older persons. JAMA. 1999;281:1714–7. - PubMed
    1. Chaves PH, Xue QL, Guralnik JM, et al. What constitutes normal hemoglobin concentration in community-dwelling disabled older women? J Am Geriatr Soc. 2004;52:1811–6. - PubMed
    1. Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med. 2006;119:327–34. - PubMed
    1. Zakai NA, Katz R, Hirsch C, et al. A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med. 2005;165:2214–20. - PubMed
    1. Culleton BF, Manns BJ, Zhang J, et al. Impact of anemia on hospitalization and mortality in older adults. Blood. 2006;107:3841–6. - PubMed

Publication types