Study of anemia in long-term care (SALT): prevalence of anemia and its relationship with the risk of falls in nursing home residents

Abstract

Anemia in nursing home residents appears to be under-recognized. For residents over 70 years, the prevalence of anemia in both male and female residents was approximately four times the rate reported in a study of older community dwellers (Salive et al., 1992). Both anemia and the use of psychoactive medications are potentially modifiable factors strongly associated with falling. Since falls and related fractures are events associated with high morbidity and mortality, each of these factors deserves special consideration for potentially reducing the risk of such events in the nursing home.

The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Tromsø Study 2001-02: a replication study

“…Similar prevalence has been found in the Longitudinal Ageing Study Amsterdam [11] and in the InChianti Study [12]. Anemia prevalence increases rapidly after the age of 50, approaching a rate of over 20% in elderly aged 85 years or older [10], and has been found to be up to 65% among nursing home residents [8]. In one third of the elderly in the NHANES III, anemia could not be explained by malnutrition or underlying disease [10].…”

“…Falls are also associated with high societal costs [6]. Previous studies have found various risk factors for falls in elderly people, including use of medications like sedatives [2, 7, 8], analgesics and antiepileptics [1], urinary incontinence [1], abnormalities in balance and gait, as well as other disabilities [1, 2, 8]. Due to the serious consequences, the identification of modifiable risk factors for falls of elderly people is important.…”

“…Late life anemia is associated with subsequent physical decline [3], like impaired physical performance not explained by disease [13], increased disability, and muscle weakness [12]. Anemia has found to be an independent risk factor for falls among hospitalized older adults [14], nursing home residents [8, 15], and among community-living elderly when injurious falls [16] or recurrent falls [11] are the outcome. However, there is a need for further studies of the association between anemia and all falls among community-living elderly people.…”

Long-Term Morbidity and Mortality Related to Falls in Hemodialysis Patients: Role of Age and Gender – A Pilot Study

“…Several studies in non-dialysis patients demonstrated that anemia correlates with falls and with mobility dysfunctions in patients with chronic kidney disease. Pandya et al [30] showed that anemia in nursing home residents was associated with more than twice the risk of falling. These results were confirmed by Duh et al [31], who showed that anemia was significantly and independently associated with a risk increase for injurious falls.…”

Medical Outcome of Patients With Dementia in a Free-Standing Psychiatric Hospital

“…Among institutionalized elderly patients, anemia was associated with an overall 1.9-to 2.2-fold increased risk of falls, 25,26 a level of risk similar to the use of psychoactive medications or age 85 years and over. 26 In models examining the effect of hemoglobin level on the incidence of falls after adjusting for age, gender, and race, the risk of falls decreased by 22% for every 1.0 g/dL increase in hemoglobin in the elderly individuals. 25 Among residents in long-term care facilities in Israel, the presence of anemia was also an independent risk factor for infections with drug-resistant Escherichia coli and Klebsiella pneumoniae , an association which matched that observed for previous antibiotic use.…”