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

Elzen, Wendy P. J. den; Willems, Jorien M.; Westendorp, Rudi G.J.; Craen, Anton J. M. de; Assendelft, W.J.J.; Gussekloo, Jacobijn

doi:10.1503/cmaj.090040

Cited by 135 publications

(108 citation statements)

References 33 publications

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“…This is in accordance to several prospective studies which have confirmed that low educated patients who live alone or in long term institutions are most prone to have cognitive and ADL impairment leading to impending death 21 . Furthermore, patients with clinical diseases such as diabetes or hypertension tend to have more cognitive impairment than those without any disease, and also they have higher mortality rates [22][23][24][25] .Cognitive reserve is a concept which has been related to the protection against dementing disorders and to the delay of onset of many central nervous system disorders 26-31 .This is also what this baseline description seems to show, although further prospective studies are needed to confirm our data. As shown, each additional point on the baseline MMSE protects from mortality by 6%.…”

supporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

Verdan

Casarsa

Perrout

et al. 2014

Arq. Neuro-Psiquiatr.

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We describe a three-year experience with patients with dementia. Method: clinical, cognitive and functional evaluation was performed by a multidisciplinary team for persons above 60 years. Mortality was assessed after three years. Results: Mini-Mental State Examination (MMSE) (n=2,074) was 15.7 (8.4). Male patients MMSE (n=758) was 15.6 (8.3) and female's (n=1315) was 15.8 (8.3). Instrumental Activities of Daily Living Scale (n=2023) was 16.5 (7.6); females (n=1277) was 16.9 (7.2) and males (n=745) was 15.7(8.2). From these patients, 12.6% (n=209) died within three years. Baseline cognition of patients still alive was higher (p,0.001) than MMSE of those who died [MMSE=16.3 (8.1) vs. 10.6 (7.6)]. Mortality rate decreased 6% (IR=0.94) for each additional point on MMSE. Higher functional status decreases the mortality rate approximately 11% (IR=0.89) independently of age, gender, and education. Conclusion: Three-year mortality rates are dependent on baseline functional and cognitive status Keywords: Alzheimer's disease, activities of daily living, Mini-Mental State Examination, mortality, outpatient service, Brazil. RESUMODescreve-se experiência de três anos em relação à mortalidade em pacientes diagnosticados com demência. Método: Foi feita avaliação clínica, cognitiva e funcional por equipe multidisciplinar em pessoas com mais de 60 anos. Mortalidade foi aferida no período de três anos. Resultados: O teste do Mini Exame do Estado Mental (MEEM) (n=2.074) foi 15,7 (8,4). MEEM dos homens (n=758) foi 15,6 (8,3) e das mulheres (n=1315) foi 15,8 (8,3). As atividades da vida diária (AVD) (n=2023) foi 16,5 (7,6); nas mulheres (n=1277) foi 16,9 (7,2) e nos homens (n=745), 15,7(8,2). Do total de pacientes, 12,6% (n=209) morreram em 3 anos. O estado cognitivo basal dos pacientes vivos ao final dos 3 anos era maior (p,0.001) que o daqueles que morreram [MEEM=16,3 (8,1) vs. 10,6 (7,6)]. Mortalidade decresceu 6% (IR=0,94) para cada ponto adicional no MEEM, ajustado para idade, gênero e educação. Mortalidade decresce em 11% (IR=0,89) independentemente da idade, gênero e educação para funcionalidade mais alta. Conclusão: A mortalidade em três anos depende do estado funcional e cognitivo basal.Palavras-chave: doença de Alzheimer, atividades de vida diária, Mini Exame do Estado Mental, mortalidade, Brasil.The latest Brazilian census has shown that people with more than 65 years of age account for 21,736,000 (11.3%) of the total population (IBGE, 2010) 1 . Data from 2000 show that despite being 9% of the total population at that time, older persons were responsible for as much as 26% of the expenditures with hospitalizations in the whole country 2 . The state of Rio de Janeiro concentrates the highest rate of older persons in the country, totaling 2,376,000 inhabitants (15%). However, to this date there is no direct study on the epidemiology of dementia, depression, and Parkinson's disease in Rio de Janeiro. If one is to calculate prevalence rates of these disorders considering the studies performed in the southern and s...

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supporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

Verdan

Casarsa

Perrout

et al. 2014

Arq. Neuro-Psiquiatr.

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“…Entretanto, estudos mais recentes mostraram que a anemia em idosos é um fator prognóstico independentemente de piores condições de saúde 2,5,6,7,8 , aumentando ainda mais a vulnerabilidade para suas complicações 5,9,10,11 .…”

Section: Introductionunclassified

Anemia e nível de hemoglobina como fatores prognósticos da mortalidade entre idosos residentes na comunidade: evidências da Coorte de Idosos de Bambuí, Minas Gerais, Brasil

et al. 2013

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O objetivo deste trabalho foi examinar a influência de baixos níveis de hemoglobina (Hb) e anemia na mortalidade entre idosos ao longo de dez anos de seguimento (1997 a 2007). Entre os 1.742 idosos participantes da linha de base da coorte de Bambuí, Minas Gerais, Brasil, 1.322 (82,3%) foram acompanhados pelo tempo médio de 8,9 anos. A probabilidade de sobrevida foi estimada pelo método de Kaplan-Meier e o modelo de riscos proporcionais de Cox foi utilizado, estimando-se os hazard ratios (HR) e intervalos de 95% de confiança (IC95%), considerando-se os potenciais fatores de confusão. Idosos anêmicos e com baixos níveis de Hb (primeiro tercil) apresentaram maior risco de óbito (HR = 2,63; IC95%: 1,83-3,76 e HR = 1,38; IC95%: 1,07-1,79, respectivamente) comparados aos não anêmicos e aos de maior nível de Hb. Os resultados demonstram que a ocorrência de anemia e/ou baixos níveis de Hb (independente do diagnóstico de anemia) devem ser interpretados e tratados como determinante independente da mortalidade nessa população idosa.

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“…The primary consequences of anemia, even mild anemia in which hemoglobin values are only marginally reduced (>9.5 g/dL), are the impairment of functional capacities and a reduced quality of life [7,8] . In elderly persons, anemia can impair physical performance and mobility, thus increasing the risk of falls.…”

Section: Introductionmentioning

confidence: 99%

“…An association between anemia in older adults and mortality has been observed in several studies, even in the absence of concomitant illness. In elderly patients, anemia is often overlooked, despite the fact that it has been shown to have potentially serious consequences [8] .…”

Section: Introductionmentioning

confidence: 99%

A Cross Sectional Study on Anaemia among Patients: A Hospital Based Study

Baid¹

2017

JMSCR

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

Cited by 135 publications

References 33 publications

Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

Anemia e nível de hemoglobina como fatores prognósticos da mortalidade entre idosos residentes na comunidade: evidências da Coorte de Idosos de Bambuí, Minas Gerais, Brasil

A Cross Sectional Study on Anaemia among Patients: A Hospital Based Study

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