Volume 53, Issue 12 p. 2106-2111

Late-Life Anemia Is Associated with Increased Risk of Recurrent Falls

Brenda W. J. H. Penninx PhD

Brenda W. J. H. Penninx PhD

From the * Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands Ortho Biotech, Clinical Affairs, LLC, Ridgewater, New Jersey Isala Klinieken, Location Weezenlanden, Zwolle, the Netherlands; § Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

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Saskia M. F. Pluijm PhD

Saskia M. F. Pluijm PhD

From the * Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands Ortho Biotech, Clinical Affairs, LLC, Ridgewater, New Jersey Isala Klinieken, Location Weezenlanden, Zwolle, the Netherlands; § Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

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Paul Lips MD, PhD

Paul Lips MD, PhD

From the * Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands Ortho Biotech, Clinical Affairs, LLC, Ridgewater, New Jersey Isala Klinieken, Location Weezenlanden, Zwolle, the Netherlands; § Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

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Richard Woodman MD

Richard Woodman MD

From the * Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands Ortho Biotech, Clinical Affairs, LLC, Ridgewater, New Jersey Isala Klinieken, Location Weezenlanden, Zwolle, the Netherlands; § Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

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Kor Miedema PhD

Kor Miedema PhD

From the * Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands Ortho Biotech, Clinical Affairs, LLC, Ridgewater, New Jersey Isala Klinieken, Location Weezenlanden, Zwolle, the Netherlands; § Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

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Jack M. Guralnik MD, PhD

Jack M. Guralnik MD, PhD

From the * Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands Ortho Biotech, Clinical Affairs, LLC, Ridgewater, New Jersey Isala Klinieken, Location Weezenlanden, Zwolle, the Netherlands; § Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

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Dorly J. H. Deeg PhD

Dorly J. H. Deeg PhD

From the * Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands Ortho Biotech, Clinical Affairs, LLC, Ridgewater, New Jersey Isala Klinieken, Location Weezenlanden, Zwolle, the Netherlands; § Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.

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First published: 06 October 2005
Citations: 127
Address correspondence to Brenda Penninx, PhD, EMGO Institute/Department of Psychiatry, VU University Medical Center, Valeriusplein 9, 1075 BG Amsterdam, the Netherlands. E-mail: [email protected]

Abstract

Objectives: To examine whether anemia is associated with a higher incidence of recurrent falls.

Design: Prospective cohort study.

Setting: Community-dwelling sample in the Netherlands.

Participants: Three hundred ninety-four participants aged 65 to 88 from the Longitudinal Aging Study Amsterdam.

measurements: Anemia was defined according to World Health Organization criteria as a hemoglobin concentration less than 12 g/dL in women and less than 13 g/dL in men. Falls were prospectively determined using fall calendars that participants filled out weekly for 3 years. Recurrent fallers were identified as those who fell at least two times within 6 months during the 3-year follow-up.

Results: Of the 394 persons, 11.9% (18 women and 29 men) had anemia. The incidence of recurrent falls was 38.3% of anemic persons versus 19.6% of nonanemic persons (P=.004). After adjustment for sex, age, body mass index, and diseases, anemia was significantly associated with a 1.91 times greater risk for recurrent falls (95% confidence interval=1.09–3.36). Poor physical function (indicated by muscle strength, physical performance, and limitations) partly mediated the association between anemia and incidence of recurrent falls.

Conclusion: Late-life anemia is common and associated with twice the risk of recurrent falls. Muscle weakness and poor physical performance appear to partly mediate this association.