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
. 2022 Mar 21;22(1):233.
doi: 10.1186/s12877-022-02937-4.

Higher hemoglobin levels are associated with better physical performance among older adults without anemia: a longitudinal analysis

Ligiana Pires Corona  1 , Flavia Cristina Drumond Andrade  2 , Tiago da Silva Alexandre  3 , Tábatta Renata Pereira de Brito  4 , Daniella Pires Nunes  5 , Yeda Aparecida de Oliveira Duarte  6
Affiliations

Higher hemoglobin levels are associated with better physical performance among older adults without anemia: a longitudinal analysis

Ligiana Pires Corona et al. BMC Geriatr. .

Abstract

Background: Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia.

Methods: The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015-2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,023 who had complete data and did not have anemia in 2010. In the follow-up, there were 567 without anemia.

Results: In analyses adjusted for age, education, comorbidities, body mass index, and physical inactivity, we found a differential association between hemoglobin concentration and SBBP by sex, with a positive interaction (β Hb*female= 0.20, 95% CI 0.04,0.37). At lower levels of hemoglobin, women have lower levels of SPPB than men, but at higher levels of hemoglobin concentration, there are no sex differences in physical performance. In addition, higher age was negatively associated with SPPB levels and cardiometabolic diseases, other diseases, and physical inactivity. Education was positively associated with physical performance.

Conclusion: Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older adults without anemia in Brazil. However, there were sex differences in this association. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia, and highlights sex differences.

Keywords: Brazil; Hemoglobin; Older adults; Physical performance; SABE study.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study sample, SABE Study, São Paulo, Brazil (from 2010 baseline to the follow-up in 2015)
Fig. 2
Fig. 2
Predicted scores of Short Physical Performance Battery (SPPB) for older men and women in Brazil. SABE Study. São Paulo, Brazil, 2010-2015
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chaves PHM, Ashar B, Guralnik JM, Fried LP. Looking at the relationship between hemoglobin concentration and prevalent mobility difficulty in older women. Should the criteria currently used to define anemia in older people be reevaluated? Journal of the American Geriatrics Society. 2002;50(7):1257–64. doi: 10.1046/j.1532-5415.2002.50313.x. - DOI - PubMed
    1. Penninx BW, Guralnik JM, Wallace R, Pahor M. Anemia is independent risk factor for physical performance decline in old age. Journal of the American Geriatrics Society. 2002;50(4):A35.
    1. Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc. 2004;52(5):719–24. doi: 10.1111/j.1532-5415.2004.52208.x. - DOI - PubMed
    1. Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PHM, Newman AB, et al. A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort - The cardiovascular health study. Archives of Internal Medicine. 2005;165(19):2214–20. doi: 10.1001/archinte.165.19.2214. - DOI - PubMed
    1. den Elzen WPJ, Willems JM, Westendorp RGJ, de Craen AJM, Assendelft WJJ, Gussekloo J. Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85-plus Study. Canadian Medical Association Journal. 2009;181(3–4):151–7. doi: 10.1503/cmaj.090040. - DOI - PMC - PubMed

Publication types