Longitudinal trends of hemoglobin levels in a Japanese population – RERF's Adult Health Study subjects

Abstract

Conflicting results have been reported on the long-term relationship between hemoglobin (Hb) level and age. We analyzed that relationship over a 40-yr period in a Japanese population, adjusting for the effects of sex, birth cohort, smoking, and anemia-associated diseases. We used Hb levels measured biennially between 1958 and 1998 for 4858 Adult Health Study subjects of the Radiation Effects Research Foundation. Using the mixed-effects model, we showed that the aging Hb profile varied by sex (P < 0.001) and birth cohort (P < 0.001). Male Hb levels peaked in the third and fourth decades and then decreased while female Hb levels dipped slightly in the third decade, peaked in the sixth and seventh, and then decreased. Levels were higher in younger cohorts. The rate of Hb decline after the sixth decade of life was greater for subjects with anemia-associated diseases (P = 0.002). The annual rate of decline between 70 and 80 yr of age for disease-free men ranged from 0.083 to 0.042 g/dL and for disease-free women from 0.049 to 0.036 g/dL. Levels were higher for ever-smokers (P < 0.001), more so for women than men. A decreasing trend in Hb concentration with advancing age was detected for elderly men and women after controlling for anemia-associated diseases, suggesting that anemia in the elderly is due not only to disease but also to aging. Cohort and smoking effects on Hb levels were also observed.

Improved Prevalence of Anemia and Nutritional Status among Japanese Elderly Participants in the National Health and Nutritional Survey Japan, 2003-2009

“…To our knowledge, this study is the first nationally representative cross-sectional study to evaluate the trends in nutritional status of community-dwelling elderly people [6,7,11]. In the current study, similar prevalence of anemia was observed in men (19.3%) and women (21.7%) compared to other developed countries.…”

“…In the United States (US), anemia prevalence increases with advancing age after 50 years and rises to more than 20% at age ≥ 85 years [4,5]. In the community dwelling elderly Japanese population, the prevalence of anemia was reported to increase with age [6]. However, this study was not conducted in a nationally representative sample and limited the highest age category to ≤ 80 years.…”

“…In order to promote a balanced diet in the elderly to prevent anemia, we need to identify dietary and life-style factors that are related to anemia risk. In the previous Japanese study [6], hemoglobin concentrations were reported to be higher in younger cohorts. The changes in diet and lifestyle may have a profound effect on the nutritional status of the Japanese elderly, and this should be examined in nationally representative samples, such as the NHNS.…”

Prevalence, incidence and types of mild anemia in the elderly: the "Health and Anemia" population-based study

“…In line with most cross-sectional studies and the findings of three longitudinal investigations, [24][25][26] hemoglobin concentration decreased and prevalence of anemia increased with increasing age. Annual rates of decline of hemoglobin concentration estimated cross-sectionally and longitudinally were similar and consistent with those reported in longitudinal surveys of 8-and 40-year duration.…”

Use of Proton Pump Inhibitors Is Associated With Anemia in Cardiovascular Outpatients

“…Moreover, decrease in average Hb during 1 year after PPI treatment was 0.38±0.87 g/dl, which was significantly greater than the reported annual decrease in Hb of 0.08-0.04 g/dl/year for men and 0.05-0.04 g/dl/year for women. 13 These findings suggest that PPI decrease Hb. It is possible that PPI were prescribed to the patients with peptic ulcer and that the peptic ulcer itself caused anemia, but patients with major bleeding within 1 year were excluded from the present study and history of peptic ulcer was not associated with low Hb in the present subjects.…”