Register for Low hemoglobin means high risk for mobility problems in elderly women
AnemiaAugust 8, 2002
2002 AUG 8 - (NewsRx.com & NewsRx.net) -- The amount of oxygen-carrying hemoglobin circulating in the blood of older women could have an impact on the risk for mobility problems, Johns Hopkins physicians have found.
Hemoglobin levels of 12-16 g/dL have long been considered normal by physicians, but a Hopkins study of more than 600 women in their 70s indicates that at a "low-normal" value of 12 g/dL, these women were as much as 1.5 times as likely to have difficulty performing daily tasks. The report is published in the July 2002 issue of the Journal of the American Geriatrics Society.
"The 12 g/dL criteria widely used by physicians to define anemia in older women needs serious scrutiny," said Paulo H.M. Chaves, MD, PhD, lead author of the study and an assistant professor of medicine at Hopkins. "Mild anemia in elderly women has often been dismissed as 'innocent', but it might be a significant health problem."
Anemia, a condition characterized by low levels of red blood cell mass, has been recognized as a major geriatric syndrome, affecting up to 32% of older women, Chaves said. Among older adults, it is often a marker of chronic diseases and can cause symptoms including fatigue, chest pain, shortness of breath and dizziness. Currently, physicians recommend their patients take some combination of iron, folate and vitamin B12 supplements for anemia associated with nutritional deficiencies. However, there is no set treatment for anemia of chronic disease.
An estimated 35% of women ages 70-80 have a hard time with general mobility tasks like walking a few blocks, climbing a flight of stairs or doing heavy housework, Chaves said. "When they have difficulty, they become more sedentary. They often lose their independence and develop substantial social and health care needs. It's a major public health problem."
For the study, Chaves and colleagues evaluated data from 633 elderly Baltimore-area women who lived independently and who had participated in the Women's Health and Aging Studies I and II of disability onset and progression. Twenty-two percent were African American. After performing routine health assessments on the women between 1992 and 1996, the investigators took blood samples, then asked them how difficult it was to walk a quarter-mile or climb 10 steps. They also measured the women's ability to walk, rise quickly from a chair several times, and keep balance.
Consistently, women with hemoglobin levels of 13-14 g/dL performed the best in the mobility tests, while those with hemoglobin levels under 12 g/dL performed the worst and those with hemoglobin levels between 12 g/dL and 13 g/dL performed intermediately. The risk of mobility problems for those with hemoglobin levels of 12 g/dL was more than twice as high as for those with hemoglobin levels of 13-14 g/dL, even after researchers adjusted for all health indicators associated with physical function decline (Chaves P, et al. Looking at the relationship between hemoglobin concentration and prevalent mobility difficulty in older women. Should the criteria currently used to define anemia in the elderly be reevaluated? Journal of the American Geriatrics Society, July 2002).
Questions remain whether anemia is indeed an independent risk factor for functional decline, or is merely a mark of coexistent chronic diseases, Chaves said. The study was supported by the U.S. National Institute on Aging. This article was prepared by Blood Weekly editors from staff and other reports.
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