Anemia Linked to Elderly Mobility Problems
Study finds older women in particular at risk
(HealthDay News) – The old TV commercial termed anemia as "iron-poor blood," and the condition's symptoms have been popularized as being tired and listless.
In truth, even being mildly anemic when you're older can bring about a plethora of serious problems, not the least of which is difficulty in moving around. The finding, from researchers at Johns Hopkins University , suggests it might be time to redefine what constitutes anemia for older adults.
A person with anemia does not have enough red blood cells, which are crucial because they contain hemoglobin, a protein that transports oxygen from the lungs to the organs and muscles of the body.
"I wouldn't say our study is definitive proof, but we need to consider where we should put the cut-off levels for what is normal, especially in the elderly," says Dr. Bimal Ashar, Johns Hopkins assistant professor of medicine and a co-author of the study, which was published in the Journal of the American Geriatrics Society .
In the research, led by Dr. Paulo H.M. Chaves, an assistant professor of medicine at Hopkins, the team evaluated 633 elderly Baltimore-area women, aged 70 to 80. Those with blood levels of hemoglobin on the low side of normal had twice the risk of mobility problems as those with higher hemoglobin levels.
In the study, the women gave blood samples so their hemoglobin levels could be evaluated, and then performed a number of mobility tests, including walking, rising quickly from a chair several times and keeping their balance.
Typically, in older adults, "12 [grams per deciliter of blood] is considered normal for women and 14 for men," Ashar says. However, women who had levels between 13 and 14 did best on the mobility tests, and those with levels under 12 did the worst. Those with hemoglobin levels between 12 and 13 performed in the middle of the best and worst. The risk of problems with movement when hemoglobin was 12 was more than twice as high as for those with higher levels, the researchers say.
Anemia affects about almost 4 million Americans, according to the National Anemia Action Council. Up to 32 percent of older women may be affected, the Hopkins researchers say. It can occur after blood loss or as a side effect of medication. It can also accompany many serious illnesses. At greatest risk are those with chronic kidney disease, heart disease or diabetes -- all diseases that tend to become more prevalent with age.
"Hemoglobin currently perceived as 'mildly low' and even 'low-normal' might have an independent, adverse impact on mobility function," Chaves concludes, adding that a redefinition of anemia in the elderly might be in order.
The research is lauded by a geriatric specialist from the University of Southern California .
"It's a very impressive study," Dr. Loren G. Lipson says. "This is something I know anecdotally, but this study is scientifically sound."
"We always attribute things to old age," he says. If an older person tells the doctor he is tired, for instance, a doctor may explain the fatigue by saying the person is getting up in years.
"It's easy to say to an older person, 'You're out of shape' or 'You're old,' when there might be another problem," he says.
In his own practice, Lipson says, he has noticed older adults with lower hemoglobin levels do have movement problems.
Older adults ought to ask their doctor about their hemoglobin levels when they get their blood work done, he adds.
"Ask what the value is," he says. "And talk about this study. A low hemoglobin level might be a hint that your doctor should look further."
It might also point to another medical problem that could be treated successfully, eventually boosting the hemoglobin, too.
"The message for doctors is that we need to conduct further study," Ashar says. To older adults, he would suggest: "If you have a low blood [hemoglobin] count, you need to be evaluated by your physician."
Treatment for anemia associated with nutritional deficiencies includes supplements of iron, folate and vitamin B12. However, anemia associated with chronic disease has no set treatment, the researchers say.
On the Web
For information on exercise and nutrition programs, read this article from the National Institute on Aging.
SOURCES:
Bimal Ashar, M.D., a ssistant professor, Department of Medicine and medical director, Executive Health Program , Johns Hopkins University School of Medicine, Baltimore, Md.; Loren G. Lipson, M.D., associate professor, medicine, and chief, division of geriatric medicine, University of Southern California Keck School of Medicine, Los Angeles; July 2002 Journal of the American Geriatrics Society
Author:
Kathleen Doheny, HealthDay Reporter
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