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Association of anemia with functional and nutritional status in the German multicenter study “GeriAnaemie2013”

Assoziation von Anämie mit dem Ernährungszustand und funktionellen Status in der deutschen Multizenterstudie „GeriAnaemie2013“

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Abstract

Objectives

Anemia and malnutrition are risk factors for frailty in older people but data from multicenter studies among German geriatric inpatients are lacking. This analysis evaluated data from the multicenter study “GerAnaemie2013” commissioned by the German Geriatric Society.

Patients and methods

The study involved an analysis of the 579 geriatric inpatients recruited in the context of the German multicenter study “GeriAnaemie2013”. Study parameters: Barthel index (BI), handgrip strength, nutritional data (e.g. loss of appetite, loss of weight and decreased food intake). Inclusion criteria: in-patient age ≥70 years, exclusion criteria: current cancer disease or cancer-associated treatment. Anemia was defined according to the World Health Organization (WHO) criteria.

Results

The mean age of patients was 81.9 years, overall prevalence of anemia 55.1 %, mean hemoglobin (Hb) level 11.9 g/dl, average BI 50.8 points and 30.3 % of all patients were at risk of malnutrition. While univariate analysis revealed a significantly lower BI in anemic patients, this association was no longer seen in multivariate analysis. Regression analysis revealed that a drug intake of > 5 drugs/day doubles the chance of suffering from anemia with an adjusted odds ratio (OR) of 2.17 (confidence interval (CI) 1.28–3.68, p = 0.004) as well as a serum albumin level below 3.5 g/dl with an adjusted OR of 2.11 (range 1.40–3.19, p < 0.001).

Conclusion

Polymedication and low serum albumin were independent risk factors for anemia in geriatric patients, probably reflecting disease severity.

Zusammenfassung

Hintergrund

Anämie und Mangelernährung sind Risikofaktoren für Frailty bei alten Patienten, doch bisher fehlen deutsche Daten aus Multizenterstudien. Die vorliegende Untersuchung basiert auf Daten der multizentrischen Studie „GeriAnaemie2013“ der Deutschen Gesellschaft für Geriatrie.

Patienten und Methoden

Es erfolgte eine Analyse der 579 stationär geriatrischen Patienten anhand folgender Studienparameter: Barthel-Index (BI), Handkraft, Appetitverlust, Gewichtsverlust, reduzierte Nahrungszufuhr. Einschlusskriterien: stationär geriatrischer Patient ≥ 70 Jahre; Ausschlusskriterien: aktuelle Tumorerkrankung oder Tumortherapie. Anämie wurde gemäß den WHO Kriterien definiert.

Ergebnisse

Das mittlere Alter der Patienten betrug 81,9 Jahren. Die Anämieprävalenz lag bei 55,1 %,der mittlere Hb-Wert bei 11,9 g/dl und der mittlere bei BI 50,8 Punkten. 30,3 % der Patienten hatten ein Risiko für Mangelernährung. In der univariaten Analyse zeigten anämische Patienten einen signifikant niedrigeren BI, jedoch war dieser Effekt in der multivariaten Analyse nicht mehr zusehen. Die binär logistische Regression zeigte bei Einnahme von > 5 Medikamenten/Tag bzw. einem erniedrigten Serumalbumin ein zweifach erhöhtes Risiko anämisch zu sein mit einer angepassten Odds Ratio (OR) von 2,17 (Range: 1,28–3,68); p = 0,004) bzw. einer angepassten OR von 2,11 (Range: 1,40–3,19; p < 0,001).

Schlussfolgerung

Polymedikation und niedriges Serumalbumin sind unabhängige Risikofaktoren für Anämie bei geriatrischen Patienten, wobei sie vermutlich die Schwere der jeweiligen Grunderkrankung spiegeln.

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Authors and Affiliations

  1. Ageing Clinical Research, Department II of Internal Medicine, University Hospital Cologne, Herderstrasse 52, 50937, Cologne, Germany

    Gabriele Röhrig MPH & Ymkje Rücker

  2. Department of Geriatrics, St. Marien-Hospital, Kerpener Straße 62, 50937, Cologne, Germany

    Gabriele Röhrig MPH

  3. Institute of Medical Statistics, Informatics and Epidemiology, Cologne, Germany

    Ingrid Becker

  4. Medical Department of Geriatrics, Klinikum Ernst von Bergmann gGmbh, Potsdam, Germany

    Romana Lenzen-Großimlinghaus

  5. Clinic for Geriatric Medicine, Kliniken Essen Mitte, Essen, Germany

    Peter Willschrei

  6. Geriatric Department, Dominikus Hospital, Berlin, Germany

    Sybille Gebauer

  7. Clinic for Geriatric Medicine and Geriatric Rehabilitation, Helios Kliniken Schwerin, Schwerin, Germany

    Mirja Modreker

  8. Clinic for Geriatric Medicine, St. Vinzenz-Hospital Dinslaken, Dinslaken, Germany

    Martin Jäger

  9. St. Marien-Hospital Borken, Department for Geriatric Medicine, Borken, Germany

    Rainer Wirth

  10. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany

    Rainer Wirth

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  1. Gabriele Röhrig MPH
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  2. Ymkje Rücker
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Corresponding author

Correspondence to Gabriele Röhrig MPH.

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Conflicts of interest

G. Röhrig, Y. Rücker, I. Becker, R.-J. Schulz, R. Lenzen-Großimlinghaus, P. Willschrei, S. Gebauer, M. Modreker, M. Jäger and R. Wirth state that there are no conflicts of interest.

The local ethics committee of the University Hospital Cologne approved the study (No. 12–322 from 13.02.2013). All studies on humans were carried out in accordance with national laws and the current version of the Declaration of Helsinki from 2013. Informed consent was obtained from all patients included in the studies.

Additional information

On behalf of the working group “Nutrition and metabolism” of the German Geriatric Society (DGG).

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Röhrig, G., Rücker, Y., Becker, I. et al. Association of anemia with functional and nutritional status in the German multicenter study “GeriAnaemie2013”. Z Gerontol Geriat 50, 532–537 (2017). https://doi.org/10.1007/s00391-016-1092-3

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