Annals of Hematology

, Volume 93, Issue 12, pp 2057–2062 | Cite as

Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study

  • Teresa Juárez-CedilloEmail author
  • Lourdes Basurto-Acevedo
  • Sara Vega-García
  • Leticia Manuel-Apolinar
  • Emiliano Cruz-Tesoro
  • José Manuel Rodríguez-Pérez
  • Normand García-Hernández
  • Nonanzit Pérez-Hernández
  • José Manuel Fragoso
Original Article


Anemia represents a global health problem that negatively impacts quality of life in elderly population; however, its impact on the geriatric syndrome of frailty is unclear. We examined the prevalence of anemia among elderly and sought a relationship between hemoglobin and the phenotype of frailty. Baseline hemoglobin quintiles and anemia were assessed in relation to frailty status in a prospective study with 1,933 older community-dwelling adults enrolled in the Study on Aging and Dementia in Mexico (SADEM). Logistic regression was used to model the relationship between frailty and Hb, adjusting for risk factors of frailty, sociodemographic data, cognitive decline, chronic diseases, and some risky habits. Prevalence of frailty was 8.3 %. Frailty risk was highest at the lowest hemoglobin quintile (<14.3 g/dL for men; <13.3 g/dL for women), and 160 (8.3 %) were anemic (<13 g/dL for men; <12 g/dL for women). The relationship between frailty and Hb levels, adjusted for age and sex, observed in the first and fifth quintiles, compared with the fourth quintile, were 1.53 (95 % confidence interval (CI), 1.46–1.60) and 1.05 (95 % CI, 1.01–1.15). After multivariate adjustment, the odds ratios (ORs) were 1.23 (95 % CI, 1.17–1.13) and 1.06 (95 % CI, 1.01–1.11). The association was not diminished by risk factors for frailty (body mass index (BMI), comorbidity, cognitive decline, smoking, alcohol consumption, etc.). In community-dwelling older adults, low hemoglobin concentrations and anemia were independently associated with increased frailty risk. This suggests that mild anemia and low Hb levels are independent, modifiable risk factors for frailty.


Anemia Frailty Mexican Aging Community-dwelling people 



This project was supported by grants from SSA/IMSS/ISSSTE-CONACYT (México), SALUD-2009-C01-114716, and the Fund for the Promotion of Health Research, Mexican Institute of Social Security, FIS/IMSS/PROT/G10/824.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Teresa Juárez-Cedillo
    • 1
    Email author
  • Lourdes Basurto-Acevedo
    • 2
  • Sara Vega-García
    • 2
  • Leticia Manuel-Apolinar
    • 2
  • Emiliano Cruz-Tesoro
    • 3
    • 4
  • José Manuel Rodríguez-Pérez
    • 5
  • Normand García-Hernández
    • 6
  • Nonanzit Pérez-Hernández
    • 5
  • José Manuel Fragoso
    • 5
  1. 1.Epidemiologic and Health Service Research Unit, Aging Area, Mexican Institute of Social SecurityNational Medical Center Century XXI, Edificio CORCE, Tercer pisoMexico CityMexico
  2. 2.Endocrine Research Unit, National Medical CenterMexican Institute of Social SecurityMexico CityMexico
  3. 3.Department of Research and Animal FacilityInstituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Mexico CityMexico
  4. 4.Immunology Research Unit, National Medical CenterMexican Social Security InstituteMexico CityMexico
  5. 5.Department of Molecular Biology and Interventional Genetic Study GroupInstituto Nacional de Cardiología Ignacio ChávezMexico CityMexico
  6. 6.Medical Research Unit in Human Genetics, Pediatric HospitalMexican Institute of Social SecurityMexico CityMexico

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