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. 2023 Jul 9;13(7):e069141.
doi: 10.1136/bmjopen-2022-069141.

Lower haemoglobin-to-red blood cell distribution width ratio is independently associated with frailty in community-dwelling older adults: a cross-sectional study

Mengpei Zhu  1   2 , Chao Wei  3 , Xiongjun Yang  2 , Yumei Huang  2 , Yushuang Xu  2 , Zhifan Xiong  4
Affiliations

Lower haemoglobin-to-red blood cell distribution width ratio is independently associated with frailty in community-dwelling older adults: a cross-sectional study

Mengpei Zhu et al. BMJ Open. .

Abstract

Objectives: The importance of blood cell markers in frailty has been studied. However, research on haemoglobin-to-red blood cell distribution width ratio (HRR) and frailty in older persons is still limited. We investigated the association between HRR and frailty in older adults.

Design: Cross-sectional population-based study.

Setting: Community-dwelling older adults older than 65 years were recruited from September 2021 to December 2021.

Participants: A total of 1296 community-dwelling older adults (age ≥65 years) in Wuhan were included in the study.

Main outcome measures: The main outcome was the presence of frailty. The Fried Frailty Phenotype Scale was used to evaluate the frailty status of the participants. Multivariable logistic regression analysis was performed to determine the relationship between HRR and frailty.

Results: A total of 1296 (564 men) older adults were included in this cross-sectional study. Their mean age was 70.89±4.85 years. Receiver operating characteristic curve analysis showed that HRR is a good predictor of frailty in older people, the area under the curve (AUC) was 0.802 (95% CI: 0.755 to 0.849), and the highest sensitivity was 84.5% and the specificity was 61.9% with the optimal critical values 9.97 (p<0.001). Multiple logistic regression analysis indicated that lower HRR (<9.97) (OR: 3.419, 1.679 to 6.964, p=0.001) is independently associated with frailty in older people, even after adjusting confounding factors.

Conclusion: Lower HRR is closely associated with an increased risk of frailty in older people. Lower HRR may be an independent risk factor for frailty in community-dwelling older adults.

Keywords: EPIDEMIOLOGY; GENERAL MEDICINE (see Internal Medicine); GERIATRIC MEDICINE.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
ROC curve for HRR (A), Hb (B) and RDW (C). (A) ROC curve indicated that the best intercept value for HRR was 9.97 (sensitivity 84.5%, specificity 61.9%, AUC=0.802, p<0.001). (B) ROC curve indicated that the best intercept value for Hb was 131.5 (sensitivity 81%, specificity 57.1%, AUC=0.742, p<0.001). (C) ROC curve indicated that the best intercept value for RDW was 13.45 (sensitivity 56.2%, specificity 81.1%, AUC=0.712, p<0.001). Hb, haemoglobin; HRR, Hb-to-RDW; RDW, red blood cell distribution width; ROC, receiver operating characteristic.
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