- The Washington Times - Monday, June 19, 2006

Older people with anemia have increased risks of hospitalization and premature death, a long-term study has found.

The study, published in the May issue of the Journals of Gerontology, is among the first to find that even a mild case of anemia, a reduction in the oxygen-carrying capacity of the blood, can elevate an older person’s risk of hospitalization and death.

“This paper shows anemia is a strong prognostic factor for major health complications,” and it dashes perceptions that “a little bit of anemia [is] a benign finding in older adults,” said Dr. Paulo Henrique M. Chaves, assistant professor of medicine and epidemiology at the Johns Hopkins University Center on Aging and Health.

Doctors often overlook anemia in clinical evaluations of older people because, although common, the condition doesn’t always produce identifiable symptoms, said Dr. Marco Pahor, director of the University of Florida’s Institute on Aging and one of the study’s co-investigators.

The researchers analyzed the relationship between anemia and subsequent hospitalizations and deaths among 3,607 persons 71 or older, who took part in epidemiological studies sponsored by the National Institute on Aging (NIA) beginning in the 1980s. The mean age of the sample was 78, and 451 of the participants were anemic, meaning their blood had lower levels of the oxygen-carrying protein hemoglobin.

The four-year follow-up found that 37 percent of the participants with anemia had died, compared with 22 percent of non-anemics. Two-thirds of anemics, compared with half of those without anemia, were hospitalized at some point during the study period. The hospitalizations also tended to be longer in anemics.

Presence of anemia was consistently higher among those hospitalized and those with diagnoses of serious and potentially life-threatening medical conditions, the follow-up found. For example, cancer was diagnosed in 16.4 percent of anemics but 10 percent of non-anemics. About one-third of anemics, compared with less than a quarter of those without anemia, endured cardiovascular conditions. The rate of congestive heart failure was 13.7 percent among non-anemics and 22.4 percent among anemics.

Anemics also had nearly twice the risk of gastrointestinal hemorrhage than other patients. Their risks for pneumonia and other infectious diseases and for diabetes also were significantly higher. Because anemia can cause fatigue, weakness and dizziness, anemics suffered more fractures than non-anemics, the study found.

The study was funded by the NIA. In addition to researchers at the University of Florida, investigators from NIA, health officials from the Netherlands and Ortho Biotech Products of Bridgewater, N.J., were involved. Dr. Chaves was not among the study’s authors but has conducted other important research on the debilitating effects of anemia.

Although anemia is common in older people, the cause can be uncertain. Dr. Pahor said about one-third of anemia cases occur in connection with underlying diseases, such as stomach ulcers, chronic infections, cancer, chronic kidney disorders and congestive heart failure. He said another third are caused by malnutrition, or iron or vitamin B-12 deficiency.

“The cause of another third of cases is just unknown,” he said. Because of that, people with pre-existing conditions that could have caused anemia were excluded from the research.

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