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

Authors

  • Brenda W. J. H. Penninx PhD,

    1. From the *Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the NetherlandsOrtho Biotech, Clinical Affairs, LLC, Ridgewater, New JerseyIsala 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,

    1. From the *Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the NetherlandsOrtho Biotech, Clinical Affairs, LLC, Ridgewater, New JerseyIsala 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,

    1. From the *Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the NetherlandsOrtho Biotech, Clinical Affairs, LLC, Ridgewater, New JerseyIsala 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,

    1. From the *Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the NetherlandsOrtho Biotech, Clinical Affairs, LLC, Ridgewater, New JerseyIsala 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,

    1. From the *Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the NetherlandsOrtho Biotech, Clinical Affairs, LLC, Ridgewater, New JerseyIsala 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,

    1. From the *Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the NetherlandsOrtho Biotech, Clinical Affairs, LLC, Ridgewater, New JerseyIsala 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

    1. From the *Institute of Research in Extramural Medicine and Department of Psychiatry, VU University Medical Center, Amsterdam, the NetherlandsOrtho Biotech, Clinical Affairs, LLC, Ridgewater, New JerseyIsala Klinieken, Location Weezenlanden, Zwolle, the Netherlands;§Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.
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Address correspondence to Brenda Penninx, PhD, EMGO Institute/Department of Psychiatry, VU University Medical Center, Valeriusplein 9, 1075 BG Amsterdam, the Netherlands. E-mail: brendap@ggzba.nl

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.

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