Skip to main content
SpringerLink
Log in

The association of hemoglobin concentration with disability and decreased mobility among older Brazilians

  • Published:
The journal of nutrition, health & aging

Abstract

Objective

To examine the association between hemoglobin concentration and disability and mobility difficulty among older adults living in São Paulo, Brazil.

Design

Cross-sectional study.

Setting

Population-based study conducted in São Paulo, Brazil.

Participants

Adults age 60 and over (n=1,256) from the third data collection wave of the SABE Study (Health, Well-being, and Aging) conducted in 2010.

Measurements

Two outcome measures were included in the analyses: 1) a difficulty to perform at least one of the instrumental activities of daily living (IADL) and 2) mobility difficulty, which was assessed using the Short Physical Performance Battery (SPPB). Logistic regression models assessed the association between hemoglobin and each of the outcome measures. All analyses were adjusted for sociodemographic and health characteristics.

Results

The prevalence of IADL disability was 26.8% and 10.7% of participants had mobility difficulty. The mean hemoglobin concentration was significantly lower in older adults who already presented disability (13.7g/dL versus 14.4g/dL among independent elderly) or decreased mobility (13.4g/dL versus 14.3g/dL among elderly with preserved mobility). Higher values of hemoglobin concentration were associated with lower the risk of IADL disability (OR=0.88; p=0.04) and mobility difficulty (OR=0.81; p=0.02). Hemoglobin concentrations showed a dose-response effect in the probability of each outcome.

Conclusions

Lower hemoglobin concentration was associated with a higher probability of IADL disability and mobility difficulty, showing a clear dose-response effect.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cesari M, Peiminx BW, Lauretani F, et al. Hemoglobin levels and skeletal muscle: results from the InCHIANTI study. J Gerontol A Biol Sci Med Sci 2004; 59(3):249–254.

    Article  PubMed  Google Scholar 

  2. Penninx B, Guralnik JM, Onder G, et al. Anemia and decline in physical performance among older persons. American Journal of Medicine 2003; 115(2):104–110.

    Article  PubMed  Google Scholar 

  3. Penninx BW, Pahor M, Cesari M, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc 2004;52(5):719–724.

    Article  PubMed  Google Scholar 

  4. Maraldi C, Ble A, Zuliani G, et al. Association between anemia and physical disability in older patients: role of comorbidity. Aging Clinical and Experimental Research 2006;18(6):485–492.

    Article  PubMed  Google Scholar 

  5. Chaves PHM, Ashar B, Guralnik JM, et al. Looking at the relationship between hemoglobin concentration and prevalent mobility difficulty in older women. Should the criteria currently used to define anemia in older people be reevaluated? Journal of the American Geriatrics Society 2002; 50(7): 1257–1264.

    Article  PubMed  Google Scholar 

  6. Patel KV, Harris TB, Faulhaber M, et al. Racial variation in the relationship of anemia with mortality and mobility disability among older adults. Blood 2007;109:4663–4670.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Yavuz BB, Cankurtaran M, Haznedaroglu IC, et al. Iron deficiency can cause cognitive impairment in geriatric patients. J Nutr Health Aging 2012;16(3):220–224.

    Article  CAS  PubMed  Google Scholar 

  8. Denny SD, Kuchibhatla MN, Cohen HI. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med 2006;119(4):327–334.

    Article  PubMed  Google Scholar 

  9. Zakai NA, Katz R, Hirsch C, et al. A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort — The cardiovascular health study. Archives of Internal Medicine 2005; 165(19):2214–2220.

    Article  PubMed  Google Scholar 

  10. Chaves P. Functional outcomes of anemia in older adults. Semin Hematol 2008;45(4):255–260.

    Article  PubMed  Google Scholar 

  11. Chaves PHM, Xue QL, Guralnik JM, et al. What constitutes normal hemoglobin concentration in community-dwelling disabled older women? Journal of the American Geriatrics Society 2004;52(11):1811–1816.

    Article  PubMed  Google Scholar 

  12. CEPAL. América Latina y el Caribe. Observatorio demográfico No 11. Proyecciones de población a largo plazo Santiago de Chile: Centro Latinoamericano y Caribeño de Demografía (CELADE) — División de Población de la CEPAL, 2011.

    Google Scholar 

  13. Schramm JMdA, Oliveira AFd, Leite IdC, et al. Transição epidemiológica e o estudo de carga de doença no Brasil [Epidemiological transition and the study of burden of disease in Brazil]. Ciência & Saúde Coletiva 2004;9:897–908.

    Article  Google Scholar 

  14. Brooker S, Jardim-Botelho A, Quinnell RJ, et al. Age-related changes in hookworm infection, anaemia and iron deficiency in an area of high Necator americanus hookworm transmission in south-eastern Brazil. Trans R Soc Trop Med Hyg 2007; 101(2): 146–154.

    Article  PubMed  Google Scholar 

  15. Guralnik JM, Eisenstaedt RS, Ferrucci L, et al. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004;104(8):2263–2268.

    Article  CAS  PubMed  Google Scholar 

  16. Carmel R. Nutritional Anemias and the Elderly. Seminars in hematology 2008;45(4):225–234.

    Article  PubMed  Google Scholar 

  17. Mukhopadhyay D, Mohanaruban K. Iron deficiency anaemia in older people: investigation, management and treatment. Age and Ageing 2002;31(2):87–91.

    Article  PubMed  Google Scholar 

  18. Monteiro CA, Levy RB, Claro RM, et al. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutrition 2011;14(01):5–13.

    Article  PubMed  Google Scholar 

  19. Zimmermann MB, Zeder C, Muthayya S, et al. Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification, Int J Obes (Lond) 2008;32(7): 1098–1104.

    Article  CAS  Google Scholar 

  20. den Elzen WPJ, Willems JM, Westendorp RGJ, et al. Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85-plus Study. Canadian Medical Association Journal 2009;181(3–4):151–157.

    Article  Google Scholar 

  21. Aung KCY, Feng L, Yap KB, et al. Serum albumin and hemoglobin are associated with physical function in community-living older persons in Singapore. The journal of nutrition, health & aging 2011;15(10):877–882.

    Article  CAS  Google Scholar 

  22. WHO. Iron deficiency anaemia. Assessment, prevention and control A guide for programme managers. Geneva, 2001:114p.

    Google Scholar 

  23. Lebrão ML, Laurenti R. Saúde, bem-estar e envelhecimento: o estudo SABE no Município de São Paulo.. Rev Bras Epidemiol 2005;8:127–141.

    Article  Google Scholar 

  24. Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower-extremity function — association with self-reported disability and prediction of mortality and nursing-home admission. Journals of Gerontology 1994;49(2):M85–M94.

    Article  CAS  PubMed  Google Scholar 

  25. Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000;55(4):M221–M231.

    Article  CAS  PubMed  Google Scholar 

  26. Freire AN, Guerra RO, Alvarado B, et al. Validity and reliability of the short physical performance battery in two diverse older adult populations in Quebec and Brazil. J Aging Healtli 2012;24(5):863–878.

    Article  Google Scholar 

  27. Icaza MC, Albala C. PROJETO SABE. Minimental State Examination (MMSE) del Studio de dementia en Chile: análisis estatístico. OPAS, 1999:1–18.

    Google Scholar 

  28. Beard JL. Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr 2001;131(2S-2):568S–579S; discussion 80S.

    CAS  PubMed  Google Scholar 

  29. Silverberg DS, Iaina A, Wexler D, et al. The pathological consequences of anaemia. Clin Lab Haematol 2001;23(1):1–6.

    Article  CAS  PubMed  Google Scholar 

  30. Roy C. Anemia in frailty. Clin Geriatr Med 2011;27(1): 67–78.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Vanasse GJ, Beriiner N. Anemia in elderly patients: an emerging problem for the 21st century. Hematology Am Soc Hematol Educ Program 2010;2010:271–275.

    Article  PubMed  Google Scholar 

  32. Ferrucci L, Harris TB, Guralnik JM, et al. Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc 1999;47(6):639–646.

    CAS  PubMed  Google Scholar 

  33. Penninx BW, Kritchevsky SB, Newman AB, et al. Inflammatory markers and incident mobility ttmitation in the elderly. J Am Geriatr Soc 2004;52(7):1105–1113.

    Article  PubMed  Google Scholar 

  34. Schaap LA, Pluijm SM, Deeg DJ, et al. Higher inflammatory marker levels in older persons: associations with 5-year change in muscle mass and muscle strength. J Gerontol A Biol Sci Med Sci 2009;64(11):1183–1189.

    Article  PubMed  Google Scholar 

  35. Barbosa D, Arruda I, Diniz A. Prevalência e caracterização da anemia em idosos do Programa de Saúde da Família. Rev bras hematol 2006;28(4).

    Google Scholar 

  36. Santos IS, Scazufca M, Lotufo PA, et al. Anemia and dementia among the elderly: the São Paulo Ageing & Health Study. Int Psychogeriatr 2012;24(1):74–81.

    Article  PubMed  Google Scholar 

  37. Silva CLA, Lima-Costa MF, Firmo JOA, et al. Hemoglobin level in older adults and the association with nutritional status and use of health services: the Bambuí Project. Cad Saude Publica 2012;28(ll):2085–2094.

    Article  PubMed  Google Scholar 

  38. Sgnaolin V, Engroff P, Ely LS, et al. Hematological parameters and prevalence of anemia among free-living elderly in south Brazil. Rev Bras Hematol Hemoter 2013;35(2):115–118.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Alvarado BE, Guerra RO, Zunzunegui MV. Gender differences in lower extremity function in Latin American elders: seeking explanations from a life-course perspective. J Aging Health 2007; 19(6): 1004–1024.

    Article  PubMed  Google Scholar 

  40. Alfieri FM, Riberto M, Gatz LS, et al. Functional mobility and balance in community-dwelling elderly submitted to multisensory versus strength exercises. Clin Interv Aging 2010;5:181–185.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Zunzunegui MV, Alvarado BE, Béland F, et al. Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med 2009;68(2):235–242.

    Article  PubMed  Google Scholar 

  42. Santos JL, Lebrão ML, Duarte YA, et al. Functional performance of the elderly in instrumental activities of daily living: an analysis in the municipality of São Paulo, Brazil. Cad Saude Publica 2008;24(4):879–886.

    Article  PubMed  Google Scholar 

  43. Reuben DB, Siu AL, Kimpau S. The predictive validity of self-report and performance-based measures of function and health. J Gerontol 1992;47(4):M106–M110.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology Faculty of Public Health, University of Sao Paulo, Sao Paulo, Brazil

    Ligiana Pires Corona & M. L. Lebrao

  2. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Oxford, USA

    F. C. Drumond Andrade

  3. Department of Medical Surgical Nursing School of Nursing, University of Sao Paulo, Sao Paulo, Brazil

    Y. A. De Oliveira Duarte

  4. Faculty of Pubhc Health, Sao Paulo, Sao Paulo, Brazil

    Ligiana Pires Corona

Authors
  1. Ligiana Pires Corona
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. C. Drumond Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y. A. De Oliveira Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. L. Lebrao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ligiana Pires Corona.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pires Corona, L., Drumond Andrade, F.C., De Oliveira Duarte, Y.A. et al. The association of hemoglobin concentration with disability and decreased mobility among older Brazilians. J Nutr Health Aging 18, 336–341 (2014). https://doi.org/10.1007/s12603-013-0389-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-013-0389-9

Key words

Search

Navigation