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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Paulo Henrique M. Chaves, MD, PhD, Departments of Medicine and Epidemiology/ Center on Aging and Health, Johns Hopkins University and Rio de Janeiro State University (UERJ), 2024 E. Monument Street, suite 2-700, Baltimore, MD 21205, 410-614-1320, pchaves@jhsph.edu, Qian-Li Xue, PhD, Epidemiology/Center on Aging and Health, Johns Hopkins University, 2024 E. Monument Street, suite 2-700, Baltimore, MD 21205, and Linda P. Fried, MD, MPH, Center on Aging and Health, Johns Hopkins Unversity, 2024 E. Monument Street, suite 2-700, Baltimore, MD 21205.
A hemoglobin concentration (Hb) <12g/dL is the widely used World Health Organization criterion to define anemia in older women, a major geriatric syndrome. This cut-off is based on statistical distribution considerations. To assess its clinical appropriateness, we investigated the relation between Hb and: (Aim1) all-cause 3-year mortality; (Aim2) mobility disability (difficulty walking ¼ mile or climbing stairs) over time; and (Aim3) cognitive/executive function, assessed by the Trail Making Test B (TMTB). The Women’s Health and Aging Studies (WHAS) I and II are two complementary prospective population-based studies investigating the epidemiology of disability progression in 1002 women ³ 65 y.o. (WHAS-I, 1993-00), and disability onset in 436 high functioning women 70-80 y.o. (WHAS-II, 1994-present). Logistic regression incorporating splines for nonlinearity was used to model the relationship between baseline Hb and mortality in WHAS 1 (Aim1), and baseline TMTB categories in WHAS-II (Aim3), adjusting for disease, disability, demographic, and other comorbidity covariates. GEE longitudinal analysis on pooled WHAS I-II data (1540 observations on 713 women 70-80 y.o) was conducted (Aim2). Risk of adverse health outcomes was substantially decreased for mid-normal (e.g., 13g/dL) vs. low-normal Hb (e.g., 12g/dL): e.g., mortality and mobility disability risks for Hb=13 g/dL vs. Hb=12g/dL were, respectively, OR 0.75 (95%CI: .56, .99) and .60 (95%CI: .44, .81). The likelihood of being in the best TMTB category vs. worst for Hb=13g/dL vs. Hb=12g/dL was OR 2.3 (95%CI: 1.1, 4.6). These findings suggest that Hb£12g/dL may be suboptimal criteria for defining anemia in older women. This is relevant for screening decision-making.
Learning Objectives:
Keywords: Anemia, Elderly
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.