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• W2085751433 abstract "Anemia is a common condition in older adults, affecting up to 50% of centenarians.1 Physical function limitations are also common in older individuals, affecting 42% of those aged 65 and older, and are more likely to occur with advancing age.2 Functional status is often measured according to how well an individual can complete activities common to daily life, which reflects muscular strength and mobility. Studies have shown an association between anemia and physical function and strength,3-6 but most studies of anemia and physical function have focused on older adults collectively and have not made distinctions between those who are in their 60s and 70s and those in their 90s and 100s. Thus, the question remains as to whether the association between anemia and physical function holds true in the very old. Considering the high prevalence of anemia and disability in the very old and the association between these two conditions, a better understanding of this association could help in characterizing potential disability in the very old, as well as encouraging the assessment and treatment of preventable forms of anemia to increase performance and promote independence. Therefore, a secondary analysis of data from the Georgia Centenarian Study (GCS)7 was recently conducted to examine differences between levels of physical function in centenarians with and without anemia. The study, approved by the University of Georgia institutional review board on human subjects, was a population-based sampling that included 244 centenarians and near centenarians (≥98) from Georgia. Details of recruitment, sampling procedures, and participant characteristics have been described elsewhere.1, 7 For the present analysis, anemia was defined as a hemoglobin level less than 13 g/dL for men and less than 12 g/dL for women.1 Measures of physical function and strength included average grip strength, knee extensor strength, activities of daily living (basic and instrumental), Short Physical Performance Battery, and GCS composite score.8 Chi-square and Wilcoxon rank sum analyses were used to determine differences in descriptive characteristics between centenarians with and without anemia. Multivariable regression analysis was performed for each measure of strength and physical function and excluded only those missing data for covariates and the dependent physical function variable for each individual analysis. Covariates included body mass index, Mini-Mental State Examination score, estimated creatinine clearance, and sum of chronic diseases present at time of interview (osteoporosis, chronic kidney disease, diabetes mellitus, chronic airway obstruction, cancer, hypertension, Parkinson's disease, and peripheral vascular disease). The average age of the participants was 100.5 and was similar for those with and without anemia (Table 1). Eighty-three percent of the study participants were female, 81.1% were white, and 41.9% lived in a skilled nursing facility. The prevalence of anemia was greater in men (66.6%) than in women (48.6%, P = .048) and tended to be greater in African Americans (63.4%) than in white participants (48.8%, P = .09) but did not differ according to residence. Bivariate analysis indicated that centenarians with anemia had 3.5 kg (~27%) lower average hand-grip strength than those without anemia. In partially (demographic characteristics; Table 1) and fully (demographic characteristics and disease states; data not shown) adjusted multiple regression models, centenarians with anemia were found to have lower grip and leg strength than those without. Anemia was not associated with lower scores on other measures of physical function in bivariate or multiple regression analyses. Chronic disease, specifically chronic kidney disease, may partly explain the lack of association between anemia and other more-complex measures of physical function. A previous study found that there were no differences in physical function ability between individuals aged 85 and older with and without anemia when inflammatory markers and creatinine clearance were controlled for.3 Poor kidney function has previously been found to be a predictor of anemia in GCS participants.1 In conclusion, anemia was associated with lower hand-grip and leg strength but not physical function in everyday activities in this population-based sample of centenarians. These observations support findings of a previous study5 that also found associations between anemia and grip and leg strength but in a “younger” older adult population. Maintenance of muscle strength is especially important for older people, because poor grip strength has been identified as a predictor of future disability.9 The robust association between anemia and hand-grip strength suggests that treating anemia, when possible, may be important for preserving strength in very old adults, potentially minimizing the decline in physical function and disability. This work was supported by the National Institute on Aging, National Institutes of Health Grant 1P01-AG17553 (LWP, Principal Investigator). A preliminary report of these data was presented at the 21st Nordic Congress of Gerontology, Copenhagen, Denmark, June 2012. The authors acknowledge the valuable assistance of the GCS recruitment, data acquisition, and data management team members. Additional investigators in the GCS: Jonathan Arnold (University of Georgia), Marla Gearing (Emory University School of Medicine), Robert C. Green (Harvard Medical School), S. Michal Jazwinski (Tulane University Health Sciences Center), Peter Martin (Iowa State University), Maurice MacDonald (Iowa State University), William R. Markesbery (deceased), Willard L. Rodgers (University of Michigan), Christopher Rott (University of Heidelberg), Ilene C. Siegler (Duke University), John L. Woodard (Wayne State University), and J. Lisa Tenover (Palo Alto Veterans Affairs Health Care System). Author Contributions: AH, DBH, MAJ: Study design, data analysis, data interpretation, and manuscript preparation. AD: Data management, data analysis and manuscript editing. MEC: Physical function assessment, data interpretation and manuscript editing. LWP: Study design and manuscript editing." @default.
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• W2085751433 date "2012-12-01" @default.
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• W2085751433 title "Associations Between Anemia and Physical Function in Georgia Centenarians" @default.
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