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Galbussera AA, Mandelli S, Rosso S, Zanetti R, Rossi M, Giacomin A, Detoma P, Riva E, Tettamanti M, Porta MGD, Lucca U. Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies. PLoS One 2021; 16:e0261899. [PMID: 34972180 PMCID: PMC8719676 DOI: 10.1371/journal.pone.0261899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0-11.9/12.9 g/dL in women/men) with all-cause mortality over 11-15 years and the effect of change in anemia status on mortality in young-old (65-84 years) and old-old (80+ years). METHODS The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used. RESULTS Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15-1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14-1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02-2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time. CONCLUSIONS Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.
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Affiliation(s)
- Alessia A. Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sara Mandelli
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Marianna Rossi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Paolo Detoma
- Laboratory of Analysis, Ospedale degli Infermi, Biella, Italy
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Matteo G. Della Porta
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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Braz VL, Duarte YADO, Corona LP. A associação entre anemia e alguns aspectos da funcionalidade em idosos. CIENCIA & SAUDE COLETIVA 2019; 24:3257-3264. [DOI: 10.1590/1413-81232018249.21142017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 01/29/2018] [Indexed: 11/21/2022] Open
Abstract
Resumo O objetivo deste artigo é avaliar a associação entre a anemia e algumas atividades de vida diária associadas à alimentação e o relato de dificuldade de mastigação e deglutição. Estudo transversal, que analisou 1.256 indivíduos de 60 anos ou mais, que fizeram parte da terceira coleta do Estudo SABE (Saúde, Bem-estar e Envelhecimento). Considerou-se anêmicos homens com hemoglobina sanguínea ≤ 13g/dL e mulheres com valores ≤ 12g/dL. Houve prevalência de anemia maior nos indivíduos que relataram redução no consumo alimentar devido a queixas de mastigação e deglutição, naqueles com dificuldade de mastigação e nos que relataram dificuldade em alimentar-se devido queixas de mastigação e deglutição. A prevalência também foi maior nos indivíduos com dificuldade de alimentar-se sozinho e de fazer compras de alimentos. Nas análises, a presença de uma queixa de mastigação e deglutição foi associada à chance de anemia quase 2 vezes maior que aqueles indivíduos sem queixas, e a presença de 2 ou 3 queixas de mastigação e deglutição foi associada à chance de 2,7. Os idosos com dificuldades de deglutição e mastigação apresentaram maior prevalência de anemia, mesmo após ajuste de outros fatores associados, com efeito dose-resposta, evidenciando a importância de um trabalho multidisciplinar com o idoso.
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Sousa NDS, Menezes TND, Silva NDA, Eulálio MDC, Paiva ADA. [Prevalence of anemia and correlation between the concentration of hemoglobin and cognitive factors among the elderly]. CIENCIA & SAUDE COLETIVA 2018. [PMID: 29538573 DOI: 10.1590/1413-81232018233.09082016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The scope of this study was to determine the prevalence of anemia and the correlation between the concentration of hemoglobin and cognitive factors in an elderly population group resident in Campina Grande, Paraiba, Brazil. It was a cross-sectional study with individuals aged 60 or older. Men with hemoglobin levels <13 g / dL and women with levels <12 g / dL were considered anemic. Sociodemographic, cognitive condition and nutritional status variables were analyzed. Statistical analysis was performed by means of simple and multiple linear regression. Among the 360 elderly patients evaluated (67.2% women), the prevalence of anemia was 12.5%. The average concentration of hemoglobin found was 13.5 g / dL and was correlated to sex variables (β = -0.44, 95% CI: -1.35, -0.85), age (β = -0.14 ; 95% CI: -0.03, -0.01), nutritional status (β = 0.16; 95% CI: 0.01, 0.06), memory impairment (β = 0.12; 95% CI: - 0.06, -0.01), and dementia (β = -0.13, 95% CI: -0.06, -0.01). Routine blood testing among the elderly makes it possible to detect and treat anemia at an early stage. Actions geared towards the elderly who show a cognitive decline should be developed in the Basic Family Health Units in order to improve the quality of life of this population.
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Affiliation(s)
- Natane Daiana Silva Sousa
- Programa de Pós-Graduação em Saúde Pública, Universidade Estadual da Paraíba (UEPB). Av. Baraúnas 351, Bodocongó. 58109-753 Campina Grande PB Brasil.
| | - Tarciana Nobre de Menezes
- Programa de Pós-Graduação em Saúde Pública, Universidade Estadual da Paraíba (UEPB). Av. Baraúnas 351, Bodocongó. 58109-753 Campina Grande PB Brasil.
| | - Nathalie de Almeida Silva
- Programa de Pós-Graduação em Saúde Pública, Universidade Estadual da Paraíba (UEPB). Av. Baraúnas 351, Bodocongó. 58109-753 Campina Grande PB Brasil.
| | - Maria do Carmo Eulálio
- Departamento de Psicologia, Centro de Ciências Biológicas e da Saúde, UEPB. Campina Grande PB Brasil
| | - Adriana de Azevedo Paiva
- Departamento de Nutrição, Centro de Ciências da Saúde, Universidade Federal do Piauí. Teresina PI Brasil
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Ferreira YD, Faria LDFC, Gorzoni ML, Gonçalves TADS, Filho JWCF, Lima THDA. Anemia in elderly residents of a long-term care institution. Hematol Transfus Cell Ther 2018; 40:156-159. [PMID: 30057989 PMCID: PMC6001937 DOI: 10.1016/j.htct.2017.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/28/2017] [Indexed: 11/21/2022] Open
Abstract
Background The Brazilian elderly population is growing exponentially, making prevention and treatment of chronic diseases a priority in this age group. Anemia in older adults is underdiagnosed, undervalued and associated with high morbimortality. Objective To assess the prevalence of anemia in the elderly residents of a long-term care institution and to correlate this with individual patient history, the use of polypharmacy and mortality. Method A retrospective study was carried out of data extracted from medical records of patients treated in 2014 at the Hospital Geriátrico e de Convalescentes Dom Pedro II under the Preventive Actions Program. Results Data were collected from 88 female (48%) and 95 male (52%) elderly residents at a long-term care institution. Patient ages ranged from 60 to 102 years with a mean age of 76.3 years. Overall, 76 participants were diagnosed with anemia, representing 41% of the sample. Of those diagnosed, 35 were women (46%) and 41 were men (54%). Conclusion Anemia in the elderly is a clinical condition associated with increased morbimortality. However, the disorder remains underdiagnosed, resulting in higher risks for older adults. The present study found 76 patients with anemia among the 183 residents at the long-term care institution. The patient profile of this population with anemia is non-smokers, male, aged between 70 and 79 years, with normochromic/normocytic anemia and taking multiple medications.
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Affiliation(s)
| | | | - Milton Luiz Gorzoni
- Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil
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Lima-Costa MF, Macinko J, Mambrini JVDM, Cesar CC, Peixoto SV, Magalhães WCS, Horta BL, Barreto M, Castro-Costa E, Firmo JOA, Proietti FA, Leal TP, Rodrigues MR, Pereira A, Tarazona-Santos E. Genomic Ancestry, Self-Rated Health and Its Association with Mortality in an Admixed Population: 10 Year Follow-Up of the Bambui-Epigen (Brazil) Cohort Study of Ageing. PLoS One 2015; 10:e0144456. [PMID: 26680774 PMCID: PMC4683049 DOI: 10.1371/journal.pone.0144456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 11/18/2015] [Indexed: 02/01/2023] Open
Abstract
Background Self-rated health (SRH) has strong predictive value for mortality in different contexts and cultures, but there is inconsistent evidence on ethnoracial disparities in SRH in Latin America, possibly due to the complexity surrounding ethnoracial self-classification. Materials/Methods We used 370,539 Single Nucleotide Polymorphisms (SNPs) to examine the association between individual genomic proportions of African, European and Native American ancestry, and ethnoracial self-classification, with baseline and 10-year SRH trajectories in 1,311 community dwelling older Brazilians. We also examined whether genomic ancestry and ethnoracial self-classification affect the predictive value of SRH for subsequent mortality. Results European ancestry predominated among participants, followed by African and Native American (median = 84.0%, 9.6% and 5.3%, respectively); the prevalence of Non-White (Mixed and Black) was 39.8%. Persons at higher levels of African and Native American genomic ancestry, and those self-identified as Non-White, were more likely to report poor health than other groups, even after controlling for socioeconomic conditions and an array of self-reported and objective physical health measures. Increased risks for mortality associated with worse SRH trajectories were strong and remarkably similar (hazard ratio ~3) across all genomic ancestry and ethno-racial groups. Conclusions Our results demonstrated for the first time that higher levels of African and Native American genomic ancestry—and the inverse for European ancestry—were strongly correlated with worse SRH in a Latin American admixed population. Both genomic ancestry and ethnoracial self-classification did not modify the strong association between baseline SRH or SRH trajectory, and subsequent mortality.
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Affiliation(s)
- M. Fernanda Lima-Costa
- Fundação Oswaldo Cruz, Instituto de Pesquisas Rene Rachou, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - James Macinko
- University of California, Los Angeles, Fielding School of Public Health, Departments of Health Policy and Management and Community Health Sciences, Los Angeles, California, United States
| | | | - Cibele C. Cesar
- Universidade Federal de Minas Gerais, Departamento de Estatística, Belo Horizonte, Minas Gerais, Brazil
| | - Sérgio V. Peixoto
- Fundação Oswaldo Cruz, Instituto de Pesquisas Rene Rachou, Belo Horizonte, Minas Gerais, Brazil
| | - Wagner C. S. Magalhães
- Universidade Federal de Minas Gerais, Departamento de Biologia Geral, Belo Horizonte, Minas Gerais, Brazil
| | - Bernardo L. Horta
- Universidade Federal de Pelotas, Departamento de Medicina Social, Pelotas, Rio Grande do Sul, Brasil
| | - Mauricio Barreto
- Fundação Oswaldo Cruz, Instituto de Pesquisas Gonçalo Muniz, Bahia, Salvador, Brasil
| | - Erico Castro-Costa
- Fundação Oswaldo Cruz, Instituto de Pesquisas Rene Rachou, Belo Horizonte, Minas Gerais, Brazil
| | - Josélia O. A. Firmo
- Fundação Oswaldo Cruz, Instituto de Pesquisas Rene Rachou, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando A. Proietti
- Fundação Oswaldo Cruz, Instituto de Pesquisas Rene Rachou, Belo Horizonte, Minas Gerais, Brazil
| | - Thiago Peixoto Leal
- Universidade Federal de Minas Gerais, Departamento de Biologia Geral, Belo Horizonte, Minas Gerais, Brazil
| | - Maira R. Rodrigues
- Universidade Federal de Minas Gerais, Departamento de Biologia Geral, Belo Horizonte, Minas Gerais, Brazil
| | | | - Eduardo Tarazona-Santos
- Universidade Federal de Minas Gerais, Departamento de Biologia Geral, Belo Horizonte, Minas Gerais, Brazil
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