Get access

Association Between Mild Anemia and Executive Function Impairment in Community-Dwelling Older Women: The Women's Health and Aging Study II

Authors

  • Paulo H. M. Chaves MD, PhD,

    1. From the *Center on Aging and Health and Departments of Medicine, Epidemiology, and §Mental Health, Johns Hopkins University, Baltimore, MarylandOpen University of the Third Age, Rio de Janeiro State University, Rio de Janeiro, BrazilLaboratory of Clinical Investigation, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.
    Search for more papers by this author
  • Michelle C. Carlson PhD,

    1. From the *Center on Aging and Health and Departments of Medicine, Epidemiology, and §Mental Health, Johns Hopkins University, Baltimore, MarylandOpen University of the Third Age, Rio de Janeiro State University, Rio de Janeiro, BrazilLaboratory of Clinical Investigation, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.
    Search for more papers by this author
  • Luigi Ferrucci MD, PhD,

    1. From the *Center on Aging and Health and Departments of Medicine, Epidemiology, and §Mental Health, Johns Hopkins University, Baltimore, MarylandOpen University of the Third Age, Rio de Janeiro State University, Rio de Janeiro, BrazilLaboratory of Clinical Investigation, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.
    Search for more papers by this author
  • Jack M. Guralnik MD, PhD,

    1. From the *Center on Aging and Health and Departments of Medicine, Epidemiology, and §Mental Health, Johns Hopkins University, Baltimore, MarylandOpen University of the Third Age, Rio de Janeiro State University, Rio de Janeiro, BrazilLaboratory of Clinical Investigation, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.
    Search for more papers by this author
  • Richard Semba MD,

    1. From the *Center on Aging and Health and Departments of Medicine, Epidemiology, and §Mental Health, Johns Hopkins University, Baltimore, MarylandOpen University of the Third Age, Rio de Janeiro State University, Rio de Janeiro, BrazilLaboratory of Clinical Investigation, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.
    Search for more papers by this author
  • Linda P. Fried MD, MPH

    1. From the *Center on Aging and Health and Departments of Medicine, Epidemiology, and §Mental Health, Johns Hopkins University, Baltimore, MarylandOpen University of the Third Age, Rio de Janeiro State University, Rio de Janeiro, BrazilLaboratory of Clinical Investigation, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland.
    Search for more papers by this author

  • This study was previously presented at the 2005 Gerontological Society of America Annual Scientific Meeting in Orlando, Florida, and the 2005 American Society of Hematology Annual Meeting, Atlanta, Georgia.

Address correspondence to Paulo H. M. Chaves, MD, PhD, Johns Hopkins Center on Aging and Health, 2024 East Monument Street, Suite 2–700, Baltimore, MD 21205. E-mail: pchaves@jhsph.edu

Abstract

OBJECTIVES: To evaluate the relationship between mild anemia and executive function in community-dwelling older women.

DESIGN: Cross-sectional.

SETTING: Community-based.

PARTICIPANTS: High-functioning subjects participating in the baseline assessment of the Women's Health and Aging Study (WHAS) II, Baltimore, Maryland, 1994 to 1996. WHAS II eligibility criteria included aged 70 to 80, a Mini-Mental State Examination score of 24 or greater, and absence of advanced disability (difficulty in no more than 1 domain of physical function). Included in this study were 364 subjects with a hemoglobin concentration 10 g/dL or greater and known executive function status.

MEASUREMENTS: Trail Making Test (TMT) Parts B and A. Tertiles of time to complete each test were used to define best (bottom), intermediate, and worst (top) performance. Tertiles of the difference TMT-B minus TMT-A were calculated. Anemia defined as hemoglobin concentration less than 12 g/dL.

RESULTS: The percentage of subjects in the worst TMT-B, TMT-A, and TMT-B minus TMT-A performance tertile was highest for those with anemia. Prevalent anemia substantially increased the likelihood of performing worst (as opposed to best) on the TMT-B (odds ratio (OR)=5.2, 95% confidence interval (CI)=1.3–20.5), TMT-A (OR=4.8, 95% CI=1.5–15.6), and TMT-B minus TMT-A (OR= 4.2, 95% CI=1.0–17.2), even after controlling for age, education, race, prevalent diseases, and relevant physiological and functional parameters.

CONCLUSION: This study provides preliminary evidence in support of the hypothesis that mild anemia might be an independent risk factor for executive function impairment in community-dwelling older adults. Whether such an association is causal or noncausal remains to be determined.

Ancillary