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Hemoglobin decline, function, and mortality in the elderly: the cardiovascular health study.
Tuesday,2012-11-06 12:26 America/Los_Angeles — eenright
| Title | Hemoglobin decline, function, and mortality in the elderly: the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2013 |
| Authors | Zakai, NA, French, B, Arnold, AM, Newman, AB, Fried, LF, Robbins, J, Chaves, P, Cushman, M |
| Journal | Am J Hematol |
| Volume | 88 |
| Issue | 1 |
| Pagination | 5-9 |
| Date Published | 2013 Jan |
| ISSN | 1096-8652 |
| Keywords | African Americans, Age Factors, Aged, Aged, 80 and over, Anemia, Diabetes Complications, Female, Follow-Up Studies, Hemoglobins, Humans, Kidney Diseases, Male, Prospective Studies, Quality of Life, Risk Factors, Sex Factors, Survival Rate, Time Factors, World Health Organization |
| Abstract | <p>While anemia is associated with poor functional and mortality outcomes in the elderly, the impact of hemoglobin decline is less studied. We evaluated the determinants and consequences of hemoglobin decline in 3,758 non-anemic participants from the Cardiovascular Health Study, a prospective cohort of community-dwelling elderly ≥65 years old at baseline and followed for up to 16 years. Hemoglobin was measured at baseline and 3 years later and anemia defined by World Health Organization (WHO) criteria. We modeled hemoglobin decline in two ways: (1) per each 1 g/dL decrease in hemoglobin and (2) development of anemia by the WHO criteria. Among participants without baseline anemia, hemoglobin decreased by 0.4 g/dL and 9% developed anemia over 3 years. Baseline increasing age, female sex, diabetes, and kidney disease predicted hemoglobin decline over 3 years. Baseline increasing age, being African-American, and kidney disease predicted anemia development over 3 years. Hemoglobin decline was associated with subsequent worse cognitive function in men and anemia development with subsequent worse cognitive function in women. Both anemia development (HR 1.39, 95% CI 1.15, 1.69) and hemoglobin decline (HR 1.11, 95% CI 1.04, 1.18 per 1 g/dL decrease) predicted subsequent mortality in men and women. Hemoglobin decreases identified a large group of elderly individuals at risk for subsequent adverse outcomes who would not be identified using the WHO anemia criteria. These data may allow clinicians to identify at-risk elderly individuals for early intervention to improve the quality and quantity of life.</p> |
| DOI | 10.1002/ajh.23336 |
| Alternate Journal | Am. J. Hematol. |
| PubMed ID | 23044913 |
| PubMed Central ID | PMC3860593 |
| Grant List | N01 HC085086 / HC / NHLBI NIH HHS / United States P30 AG-024827 / AG / NIA NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States R01 AG-15928 / AG / NIA NIH HHS / United States R01 HL075366 / HL / NHLBI NIH HHS / United States N01 HC-35129 / HC / NHLBI NIH HHS / United States N01 HC-85080 / HC / NHLBI NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States U01 HL-080295 / HL / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States R01 HL-075366 / HL / NHLBI NIH HHS / United States N01 HC-85082 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States N01 HC-85081 / HC / NHLBI NIH HHS / United States N01 HC-85079 / HC / NHLBI NIH HHS / United States R01 AG-023629 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01 HC-85086 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01 HC-85083 / HC / NHLBI NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01 HC-45133 / HC / NHLBI NIH HHS / United States R01 AG-20098 / AG / NIA NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01 HC-85084 / HC / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R01 AG-027058 / AG / NIA NIH HHS / United States |