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Anemia is Risk Factor for Physical Decline

by Raquel Gaerlan

Geriatric Times

September/October 2003

Vol. IV

Issue 5

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Anemia affects about 13% of people over age 70. A recent study published in the American Journal of Medicine (2003;115[2]:104-110) showed that anemia increases the risk of physical decline in older people. Researchers from the Sticht Center on Aging at the Wake Forest University School of Medicine followed 1,146 participants aged 71 and over in a four-year prospective cohort study. Assessment of three physical tasks included standing balance, a timed 2.4 m walk and ability to rise from a chair. These activities were scored on a five-point scale (0=inability to do the test; 4=top performance) and were combined in a 0 (poor) to 12 (excellent) summary scale.

Subjects with anemia experienced a mean decline of 2.3 points, while subjects with borderline anemia had a mean decline of 1.8 points; and subjects without anemia had a mean decline of 1.4 points. The relationship between anemia and physical decline was also present in subjects without diseases associated with anemia (e.g., cancer, infectious disease, renal failure), suggesting that anemia is a risk factor in itself. According to the World Health Organization (WHO), anemia is defined as a hemoglobin concentration of <12 g/dL in women and <13 g/dL in men. For this study, borderline anemia was defined as having a hemoglobin concentration within 1 g/dL above the WHO criteria.
The researchers found that decline in physical performance scores predicted hospitalization, nursing home admission and mortality in a previous study using the same data. A 25% decline in physical performance has been shown to increase the risk of hospitalization by 150%, nursing home admission by 200% and disability by 400%.

Symptoms of anemia include fatigue, muscle weakness, shortness of breath and rapid heart beat, yet the warning signs are often too subtle to detect. "Our research suggests that anemia deserves more attention," said Brenda Penninx, Ph.D., lead investigator, in a press release. "It seems to be an important risk factor for physical decline and is potentially treatable. We need to learn whether treatment can help restore physical function or prevent a physical decline"--RG