Original StudyCross-Sectional and Longitudinal Associations Between Anemia and Frailty in Older Australian Men: The Concord Health and Aging in Men Project
Section snippets
Study Participants
The Concord Health and Aging in Men Project (CHAMP) is an epidemiologic study of a wide range of health issues in Australian men aged 70 years and over.12 Participants in the CHAMP were recruited from a well-defined urban geographic region (the Local Government Areas of Burwood, Canada Bay and Strathfield) near Concord Hospital in Sydney, Australia. The sampling frame was the New South Wales Electoral Roll. Electoral registration is compulsory in Australia. The only exclusion criterion was
Baseline Characteristics of Participants
Characteristics of the analyzed sample are summarized in Table 1. A valid hemoglobin measure was obtained from 97.7% (1666) of the total sample of men (1705 men) who participated in the study at baseline. The mean (SD) hemoglobin concentration was 14.3 (1.3) g/dL. The mean age of the study population was 77 (range 70–97) years. Forty percent were aged between 70 and 74 years, 31% were between 75 and 79 years, 15% were between 80 and 85 years and 14% were aged above 85 years. Prevalence of
Discussion
In this large epidemiologic study, among community-dwelling older men, we show a high prevalence of both anemia and frailty among older community dwelling men. We demonstrate cross-sectional and longitudinal associations between anemia and frailty, even after full adjustment by confounders and covariates of clinical significance. There are only 2 other cross-sectional studies examining associations between anemia and frailty.10, 11 To our knowledge, our study is the first population-based
Conclusions
Our findings suggest that there might be a number of different biological mechanisms for how anemia might contribute to the frailty syndrome. Low hemoglobin levels among patients may alert clinicians to the increased risk of frailty.
Acknowledgments
The authors thank all the staff working on the CHAMP and the participants in the project. They would like to thank Dr Patrick Kelly for his statistical help.
References (45)
Anemia and the frail elderly
Semin Hematol
(2008)- et al.
Prevalence of anemia in persons 65 years and older in the United States: Evidence for a high rate of unexplained anemia
Blood
(2004) - et al.
The Physical Activity Scale for the Elderly (PASE): Development and evaluation
J Clin Epidemiol
(1993) - et al.
Use of albumin as a predictor of mortality in community-dwelling and institutionalized elderly populations
J Clin Epidemiol
(1996) - et al.
Anemia and decline in physical performance among older persons
Am J Med
(2003) - et al.
Proinflammatory state, hepcidin, and anemia in older persons
Blood
(2010) - et al.
Men in Australia Telephone Survey (MATeS): A national survey of the reproductive health and concerns of middle-aged and older Australian men
Lancet
(2005) - et al.
Frailty in older adults: Evidence for a phenotype
J Gerontol A Biol Sci Med Sci
(2001) - et al.
Frailty, an emerging research and clinical paradigm: Issues and controversies
J Gerontol Med Sci
(2007) - et al.
Anemia: Not just an innocent bystander?
Arch Intern Med
(2003)
Using longitudinal data from the Health Survey for England to resolve discrepancies in thresholds for haemoglobin in older adults
Br J Haematol
Prevalence and causes of anemia in a geriatric hospitalized population
Gerontology
Mechanisms of unexplained anemia in the nursing home
J Am Geriatr Soc
Anemia is associated with disability and decreased physical performance and muscle strength in the elderly
J Am Geriatr Soc
Impact of anemia and cardiovascular disease on frailty status of community-dwelling older women: The Women's Health and Aging Studies I and II
J Gerontol A Biol Sci Med Sci
Serum interleukin-6 and hemoglobin as physiological correlates in the geriatric syndrome of frailty: A pilot study
J Am Geriatr Soc
Cohort profile: The Concord Health and Ageing in Men Project (CHAMP)
Int J Epidemiol
A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity
Med Care
WHO Technical Reports Series 405
The definition of anemia in older persons
JAMA
Hemoglobin concentration and the risk of death in older adults: Differences by race/ethnicity in the NHANES III follow-up
Br J Haematol
Serum albumin levels as an independent predictor of 4-year mortality in a community-dwelling 80-year-old population
Aging Clin Exp Res
Cited by (0)
The Concord Health and Aging in Men Project study is funded by the National Health and Medical Research Council (Grant no:301916) and the Aging and Alzheimer's Institute. The lead author is funded by the Australian Research Council Center of Excellence in Population Aging Research.
The views expressed are those of the authors, not of the funders. Data analysis and interpretation were carried out by the authors independently of the funding sources based on the available data. The corresponding author had full access to the survey data.
The funding body played no role in the formulation of the design, methods, subject recruitment, data collection, analysis, or preparation of this article.
The authors declare no conflicts of interest.