Looking at the Relationship Between Hemoglobin Concentration and Prevalent Mobility Difficulty in Older Women. Should the Criteria Currently Used to Define Anemia in Older People Be Reevaluated

作者: Paulo H. M. Chaves , Bimal Ashar , Jack M. Guralnik , Linda P. Fried

DOI: 10.1046/J.1532-5415.2002.50313.X

关键词:

摘要: OBJECTIVES: The World Health Organization (WHO) and other currently used criteria for defining anemia in older women are mainly based on statistical distribution considerations. To explore their clinical appropriateness, we evaluated the relationship between hemoglobin (Hb) concentration, prevalent mobility difficulty, Summary Performance Score (SPS). DESIGN: Cross-sectional study. SETTING: Two population-based studies, Women's Aging Studies I II, Baltimore, Maryland. PARTICIPANTS: Six hundred thirty-three community-dwelling aged 70 to 80 with Hb levels obtained within 90 days from baseline assessment. MEASUREMENTS: Mobility difficulty (self-reported walking one-quarter of a mile or climbing 10 steps (primary outcome)). SPS, performance-based summary measure lower extremity function that combines results walking, chair stands, balance tests (secondary outcome). RESULTS: prevalence was not constant WHO “normal” range (12.0–16.0 g/dL). For example, 13.5 g/dL associated significantly than 12.0 (OR = 0.68, 95% CI 0.47–0.93), even after adjustment chronic diseases relevant health indicators. A consistent trend improvement scores increasing categories less g/dL, 13.0g/dL, 13.0–14.0 observed. CONCLUSION: Our findings raise two hypotheses: (1) perceived as “mildly-low” “low-normal” might have an independent, adverse effect function, (2) be suboptimal criterion women. Formal testing these hypotheses prove anemia- disability–related decision-making.

参考文章(29)
Donald W. Cockcroft, Henry Gault, Prediction of Creatinine Clearance from Serum Creatinine Nephron. ,vol. 16, pp. 31- 41 ,(1976) , 10.1159/000180580
P R Dallman, R Yip, C Johnson, Prevalence and causes of anemia in the United States, 1976 to 1980. The American Journal of Clinical Nutrition. ,vol. 39, pp. 437- 445 ,(1984) , 10.1093/AJCN/39.3.437
Marshal F. Folstein, Susan E. Folstein, Paul R. McHugh, “Mini-mental state” Journal of Psychiatric Research. ,vol. 12, pp. 189- 198 ,(1975) , 10.1016/0022-3956(75)90026-6
Diana J Fleming, Paul F Jacques, Katherine L Tucker, Joseph M Massaro, Ralph B D'Agostino, Peter WF Wilson, Richard J Wood, Iron status of the free-living, elderly Framingham Heart Study cohort: an iron-replete population with a high prevalence of elevated iron stores The American Journal of Clinical Nutrition. ,vol. 73, pp. 638- 646 ,(2001) , 10.1093/AJCN/73.3.638
Herman Nilsson-Ehle, Rudolf Jagenburg, Sten Landahl, Alvar Svanborg, Blood haemoglobin declines in the elderly: implications for reference intervals from age 70 to 88. European Journal of Haematology. ,vol. 65, pp. 297- 305 ,(2000) , 10.1034/J.1600-0609.2000.065005297.X
M Olivares, E Hertrampf, MT Capurro, D Wegner, Prevalence of anemia in elderly subjects living at home: role of micronutrient deficiency and inflammation European Journal of Clinical Nutrition. ,vol. 54, pp. 834- 839 ,(2000) , 10.1038/SJ.EJCN.1601099
Luigi Ferrucci, Tamara B. Harris, Jack M. Guralnik, Russell P. Tracy, Maria-Chiara Corti, Harvey J. Cohen, Brenda Penninx, Marco Pahor, Robert Wallace, Richard J. Havlik, Serum IL-6 level and the development of disability in older persons. Journal of the American Geriatrics Society. ,vol. 47, pp. 639- 646 ,(1999) , 10.1111/J.1532-5415.1999.TB01583.X
D. A. Lipschitz, C. O. Mitchell, C. Thompson, The anemia of senescence American Journal of Hematology. ,vol. 11, pp. 47- 54 ,(1981) , 10.1002/AJH.2830110106
H. Hassaballa, Anemia in older patients. JAMA. ,vol. 282, pp. 2001- 2001 ,(1999) , 10.1001/JAMA.282.21.2001