Hemoglobin concentration is associated with self-reported disability and reduced physical performance in a community dwelling population of nonagenarians: the Mugello Study

Abstract

People aged 90 and older represent a fast-growing population segment who deserve specific attention and research. Aging is associated with a progressive decrease in hemoglobin concentration, which predicts adverse outcome, such as mortality, morbidity, frailty and disability. Whether this association is independent from increased prevalence of comorbidity, causing both anemia and reduced physical function is yet under debate. The aim of this study is to explore the relationship between hemoglobin concentration and self-reported disability and reduced physical performance in a community dwelling population of nonagenarians. Data presented were collected in the framework of the Mugello Study, a clinical epidemiologic survey of nonagenarians living in the Mugello area (Tuscany, Italy). 251 persons (177 women, age 93.2 ± 3.3 years; 74 men, age 92.2 ± 2.5 years) underwent a blood draw. Along with hemoglobin concentration, self-reported disability (basic and instrumental activities of daily living), physical performance (Short Physical Performance Battery), self-reported physical activity and muscular strength (handgrip measurement) were assessed. Covariates, inherent sociodemographic and health indicators and comorbidities were also included in the analysis. This study confirms that anemia is very common in the oldest old, with a significantly higher prevalence in males (50% in men vs 24% in women). Multiple linear regression analysis, including all the comorbid conditions as confounding factors, shows that hemoglobin concentration is independently associated with handgrip strength, self-reported physical activity and disability in dressing, and taking a shower/bath. In conclusion, results from this study confirm that in the oldest old, low hemoglobin concentration is strongly associated with self-reported disability and decline of physical performance independent of comorbidity.

The Association with Dietary Patterns and Risk of Anemia in Japanese Elderly

“…According to a previous study, resistance exercise improved hemoglobin status by increasing heme synthesis in the bone marrow in moderately iron-deficient rats (36), which could decrease the risk of anemia among the older elderly. A previous study reported that blood hemoglobin level was associated with physical performance in the community-dwelling elderly, similar to our result (37).…”

Factors associated with low handgrip strength in older people: data of the Study of Chronic Diseases (Edoc-I)

“…This study also confirms that the effect of anemia on the occurrence of low HGS is independent of other sociodemographic, anthropometric, and clinical factors [28]. Although a possible link between reduced HGS and the multiple etiological factors of anemia beyond the scope of the present study is recognized, a plausible explanation for the findings is that the reduction of hemoglobin levels decreases the oxygen consumption capacity of the muscles, leading to tissue hypoxia that promotes the decline of physiological reserve [29].…”

Iron Deficiency Anemia in Older Females: A Comparison Between Community-Dwelling Individuals and Nursing Home Residents in the Southwest of Iran

“…In the current study, the level of hemoglobin and ferritin decreased with age, and in particular in the nursing home residents caused by several reasons, including reduced erythropoietin secretion, reduced hematopoietic reserve, decreased intake of iron and vitamins, and the chronic illnesses that occur with chronic inflammatory diseases (30). The results of the current study were consistent with those of other studies (3,4,9,13,15,29,31,33).…”