ANEMIA INCREASES RISK OF MORTALITY AND DECLINE IN FUNCTION AND COGNITION

Am J Med 2006;119:327-334.

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NEW YORK (Reuters Health) Apr 26 - Anemia is more common in elderly black subjects than in whites, according to new study in the April issue of the American Journal of Medicine, and elderly patients with anemia have an increased risk for mortality and cognition and functional decline.

Dr. Harvey Jay Cohen and colleagues from Duke University Medical Center, Durham, North Carolina, prospectively studied 1744 men and women at least 71 years of age. The team obtained hemoglobin levels for the subjects at baseline in 1992.

Katz and instrumental activities of daily living were used to measure functional status at the 4-year follow-up interview. The Short Portable Mental Status Questionnaire (SPMSQ) was used to measure cognition. Using the National Death Index, the team included all deaths through 2000.

The subjects had a mean age of 78 years. The prevalence of anemia was 24% using World Health Organization criteria, and after adjustment for age, education, estimated glomerular filtration rate, hospitalization, and comorbidity, the odds ratio for anemia was 3.0 in blacks compared to whites.

The adjusted risk ratios for 8-year mortality were 1.7 and 1.8 for blacks and whites, respectively. The adjusted relative risk of death did not differ by sex or race. A strong association was found between anemia and poor physical function and cognitive function. Anemia was predictive of decreases in both over 4 years.

Anemic women had a greater decrease in cognition than anemic men. "The greater decrease in cognition for women is a bit surprising given the generally greater prevalence of memory impairment in men in the community," Dr. Cohen's team writes. "This may indicate a particular sensitivity of women to the effects of anemia than other causes of memory impairment."