Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies
Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0-11.9/12.9 g/dL...
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| creator | Galbussera, Alessia A Mandelli, Sara Rosso, Stefano Zanetti, Roberto Rossi, Marianna Giacomin, Adriano Detoma, Paolo Riva, Emma Tettamanti, Mauro Porta, Matteo G Della Lucca, Ugo |
| description | Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0-11.9/12.9 g/dL in women/men) with all-cause mortality over 11-15 years and the effect of change in anemia status on mortality in young-old (65-84 years) and old-old (80+ years).
The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used.
Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15-1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14-1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02-2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend |
| doi_str_mv | 10.1371/journal.pone.0261899 |
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The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used.
Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15-1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14-1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02-2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time.
Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0261899</identifier><identifier>PMID: 34972180</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Age Factors ; Aged ; Aged, 80 and over ; Anemia ; Anemia - epidemiology ; Anemia - mortality ; Biology and Life Sciences ; Care and treatment ; Cognitive ability ; Cohort analysis ; Cohort Studies ; Dementia ; Demographic aspects ; Epidemiology ; Female ; Folic acid ; Geriatrics ; Health risks ; Hemoglobin ; Hemoglobins - analysis ; Hospitals ; Humans ; Informed consent ; Italy - epidemiology ; Kidney diseases ; Laboratories ; Male ; Medicine and Health Sciences ; Men ; Mortality ; Neurosciences ; Nurses ; Older people ; Population ; Population studies ; Population-based studies ; Prospective Studies ; Psychologists ; Questionnaires ; Risk ; Risk Factors ; Vitamin B12 ; Vitamin deficiency</subject><ispartof>PloS one, 2021-12, Vol.16 (12), p.e0261899</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Galbussera et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Galbussera et al 2021 Galbussera et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-341988b106e31c552a56ae4f7be2c95ce07dff1d719a0ddad3da30030cd163de3</citedby><cites>FETCH-LOGICAL-c692t-341988b106e31c552a56ae4f7be2c95ce07dff1d719a0ddad3da30030cd163de3</cites><orcidid>0000-0003-0452-3215</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719676/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719676/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23868,27926,27927,53793,53795</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34972180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Azoulay, Laurent</contributor><creatorcontrib>Galbussera, Alessia A</creatorcontrib><creatorcontrib>Mandelli, Sara</creatorcontrib><creatorcontrib>Rosso, Stefano</creatorcontrib><creatorcontrib>Zanetti, Roberto</creatorcontrib><creatorcontrib>Rossi, Marianna</creatorcontrib><creatorcontrib>Giacomin, Adriano</creatorcontrib><creatorcontrib>Detoma, Paolo</creatorcontrib><creatorcontrib>Riva, Emma</creatorcontrib><creatorcontrib>Tettamanti, Mauro</creatorcontrib><creatorcontrib>Porta, Matteo G Della</creatorcontrib><creatorcontrib>Lucca, Ugo</creatorcontrib><title>Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0-11.9/12.9 g/dL in women/men) with all-cause mortality over 11-15 years and the effect of change in anemia status on mortality in young-old (65-84 years) and old-old (80+ years).
The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used.
Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15-1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14-1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02-2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time.
Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.</description><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia</subject><subject>Anemia - epidemiology</subject><subject>Anemia - mortality</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Cognitive ability</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Dementia</subject><subject>Demographic aspects</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Folic acid</subject><subject>Geriatrics</subject><subject>Health risks</subject><subject>Hemoglobin</subject><subject>Hemoglobins - analysis</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Informed consent</subject><subject>Italy - epidemiology</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Men</subject><subject>Mortality</subject><subject>Neurosciences</subject><subject>Nurses</subject><subject>Older people</subject><subject>Population</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prospective Studies</subject><subject>Psychologists</subject><subject>Questionnaires</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Vitamin B12</subject><subject>Vitamin 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anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies</title><author>Galbussera, Alessia A ; Mandelli, Sara ; Rosso, Stefano ; Zanetti, Roberto ; Rossi, Marianna ; Giacomin, Adriano ; Detoma, Paolo ; Riva, Emma ; Tettamanti, Mauro ; Porta, Matteo G Della ; Lucca, Ugo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-341988b106e31c552a56ae4f7be2c95ce07dff1d719a0ddad3da30030cd163de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia</topic><topic>Anemia - epidemiology</topic><topic>Anemia - mortality</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Cognitive ability</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Dementia</topic><topic>Demographic 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Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Galbussera, Alessia A</au><au>Mandelli, Sara</au><au>Rosso, Stefano</au><au>Zanetti, Roberto</au><au>Rossi, Marianna</au><au>Giacomin, Adriano</au><au>Detoma, Paolo</au><au>Riva, Emma</au><au>Tettamanti, Mauro</au><au>Porta, Matteo G Della</au><au>Lucca, Ugo</au><au>Azoulay, Laurent</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-12-31</date><risdate>2021</risdate><volume>16</volume><issue>12</issue><spage>e0261899</spage><pages>e0261899-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0-11.9/12.9 g/dL in women/men) with all-cause mortality over 11-15 years and the effect of change in anemia status on mortality in young-old (65-84 years) and old-old (80+ years).
The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used.
Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15-1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14-1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02-2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time.
Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34972180</pmid><doi>10.1371/journal.pone.0261899</doi><tpages>e0261899</tpages><orcidid>https://orcid.org/0000-0003-0452-3215</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-12, Vol.16 (12), p.e0261899 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2615610974 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Age Factors Aged Aged, 80 and over Anemia Anemia - epidemiology Anemia - mortality Biology and Life Sciences Care and treatment Cognitive ability Cohort analysis Cohort Studies Dementia Demographic aspects Epidemiology Female Folic acid Geriatrics Health risks Hemoglobin Hemoglobins - analysis Hospitals Humans Informed consent Italy - epidemiology Kidney diseases Laboratories Male Medicine and Health Sciences Men Mortality Neurosciences Nurses Older people Population Population studies Population-based studies Prospective Studies Psychologists Questionnaires Risk Risk Factors Vitamin B12 Vitamin deficiency |
| title | Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies |
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