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Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research article

The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Tromsø Study 2001-02: a replication study

Authors: Laila Arnesdatter Hopstock, Elisabeth Bøe Utne, Alexander Horsch, Tove Skjelbakken

Published in: BMC Geriatrics | Issue 1/2017

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Abstract

Background

Falls are common among elderly people, and the risk increase with age. Falls are associated with both health and social consequences for the patient, and major societal costs. Identification of risk factors should be investigated to prevent falls. Previous studies have shown anemia to be associated with increased risk of falling, but the results are inconsistent. The aim of this study was to investigate the association between anemia and self-reported falls among community-living elderly people. The study is a replication of the study by Thaler-Kall and colleagues from 2014, who studied the association between anemia and self-reported falls among 967 women and men 65 years and older in the KORA-Age study from 2009.

Methods

We included 2441 participants (54% women) 65 years and older from the population-based Tromsø 5 Study 2001-2002. Logistic regression models were used to investigate the association between anemia (hemoglobin <12 g/dL in women and <13 g/dL in men) or hemoglobin level and self-reported falls last year, adjusted for sex, age, medication use and disability. Further, associations between combinations of anemia and frailty or disability, and falls, were investigated.

Results

No statistical significant associations were found between anemia and falls (OR 95% CI: 0.83, 0.50-1.37) or hemoglobin level and falls (OR, 95% CI: 0.94, 0.81-1.09), or with combinations of anemia and frailty or disability, and falls (OR, 95%: CI: 0.94, 0.40-2.22 and 0.78, 0.34-1.81, respectively).

Conclusions

In this replication analysis, in accordance with the results from the original study, no statistically significant association between anemia or hemoglobin and falls was found among community-living women and men aged 65 years or older.
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Literature
1.
go back to reference Tromp AM, Smit JH, Deeg DJ, Bouter LM, Lips P. Predictors for falls and fractures in the longitudinal aging study Amsterdam. J Bone Mine Res. 1998;13:1932–9.CrossRef Tromp AM, Smit JH, Deeg DJ, Bouter LM, Lips P. Predictors for falls and fractures in the longitudinal aging study Amsterdam. J Bone Mine Res. 1998;13:1932–9.CrossRef
2.
go back to reference Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.CrossRefPubMed Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.CrossRefPubMed
3.
go back to reference Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med. 2006;119:327–34.CrossRefPubMed Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med. 2006;119:327–34.CrossRefPubMed
4.
go back to reference Izaks GJ, Westendorp RJ, Knook DL. THe definition of anemia in older persons. JAMA. 1999;281:1714–7.CrossRefPubMed Izaks GJ, Westendorp RJ, Knook DL. THe definition of anemia in older persons. JAMA. 1999;281:1714–7.CrossRefPubMed
5.
go back to reference Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing. 1997;26:189–93.CrossRefPubMed Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing. 1997;26:189–93.CrossRefPubMed
6.
go back to reference Heinrich S, Weigelt I, Rapp K, Becker C, Rissmann U, König HH. Fall and fracture prevention based on the National Expert Standard. Z Gerontol Geriatr. 2012;45:128–37.CrossRefPubMed Heinrich S, Weigelt I, Rapp K, Becker C, Rissmann U, König HH. Fall and fracture prevention based on the National Expert Standard. Z Gerontol Geriatr. 2012;45:128–37.CrossRefPubMed
7.
go back to reference Hartikainen S, Lonnroos E, Louhivuori K. Medication as a risk factor for falls: critical systematic review. J Gerontol A Biol Sci Med Sci. 2007;62:1172–81.CrossRefPubMed Hartikainen S, Lonnroos E, Louhivuori K. Medication as a risk factor for falls: critical systematic review. J Gerontol A Biol Sci Med Sci. 2007;62:1172–81.CrossRefPubMed
8.
go back to reference Pandya N, Bookhart B, Mody SH, Funk Orsini PA, Reardon G. Study of anemia in long term care (SALT): prevalence of anemia and its relationship with the risk of falls in nursing home residents. Curr Med Res Opin. 2008;24:2139–49.CrossRefPubMed Pandya N, Bookhart B, Mody SH, Funk Orsini PA, Reardon G. Study of anemia in long term care (SALT): prevalence of anemia and its relationship with the risk of falls in nursing home residents. Curr Med Res Opin. 2008;24:2139–49.CrossRefPubMed
9.
go back to reference WHO. Worldwide prevalence of anemia: WHO global database on anemia. Geneva: WHO; 2008. WHO. Worldwide prevalence of anemia: WHO global database on anemia. Geneva: WHO; 2008.
10.
go back to reference Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004;104:2263–8.CrossRefPubMed Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004;104:2263–8.CrossRefPubMed
11.
go back to reference Penninx BW, Pluijm SM, Lips P, Woodman R, Miedema K, Guralnik JM, et al. Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc. 2005;53:2106–11.CrossRefPubMed Penninx BW, Pluijm SM, Lips P, Woodman R, Miedema K, Guralnik JM, et al. Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc. 2005;53:2106–11.CrossRefPubMed
12.
go back to reference Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc. 2004;52:719–24.CrossRefPubMed Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc. 2004;52:719–24.CrossRefPubMed
13.
go back to reference Penninx BWJH, Guralnik JM, Onder G, Ferrucci L, Wallace RB, Pahor M. Anemia and decline in physical performance among older persons. Am J Med. 2003;115:104–10.CrossRefPubMed Penninx BWJH, Guralnik JM, Onder G, Ferrucci L, Wallace RB, Pahor M. Anemia and decline in physical performance among older persons. Am J Med. 2003;115:104–10.CrossRefPubMed
14.
go back to reference Dharmarajan TS, Avula S, Norkus EP. Anemia increases risk for falls in hospitalized older adults: an evaluation of falls in 362 hospitalized, ambulatory, long-term care, and community patients. J Am Med Dir Assoc. 2007;8:Suppl-e15.CrossRef Dharmarajan TS, Avula S, Norkus EP. Anemia increases risk for falls in hospitalized older adults: an evaluation of falls in 362 hospitalized, ambulatory, long-term care, and community patients. J Am Med Dir Assoc. 2007;8:Suppl-e15.CrossRef
15.
go back to reference Dharmarajan TSMFA, Norkus EPPF. Mild anemia and the risk of falls in older adults from nursing homes and the community. J Am Med Dir Assoc. 2004;5:395–400.CrossRefPubMed Dharmarajan TSMFA, Norkus EPPF. Mild anemia and the risk of falls in older adults from nursing homes and the community. J Am Med Dir Assoc. 2004;5:395–400.CrossRefPubMed
16.
go back to reference Duh MS, Mody SH, Lefebvre P, Woodman RC, Buteau S, Piech CT. Anaemia and the risk of injurious falls in a community-dwelling elderly population. Drugs Aging. 2008;25:325334.CrossRef Duh MS, Mody SH, Lefebvre P, Woodman RC, Buteau S, Piech CT. Anaemia and the risk of injurious falls in a community-dwelling elderly population. Drugs Aging. 2008;25:325334.CrossRef
17.
go back to reference Thaler-Kall K, Döring A, Peters A, Thorand B, Grill E, Koenig W, Horsch A, Meisinger C. Association between anemia and falls in community-dwelling older people: cross-sectional results from the KORA-Age study. BMC Geriatr. 2014;14:1–8.CrossRef Thaler-Kall K, Döring A, Peters A, Thorand B, Grill E, Koenig W, Horsch A, Meisinger C. Association between anemia and falls in community-dwelling older people: cross-sectional results from the KORA-Age study. BMC Geriatr. 2014;14:1–8.CrossRef
18.
go back to reference Peters A, Doring A, Ladwig KH, Meisinger C, Linkohr B, Autenrieth C, et al. Multimorbidity and successful aging: the population-based KORA-age study. Z Gerontol Geriatr. 2011;44(Suppl 54). Peters A, Doring A, Ladwig KH, Meisinger C, Linkohr B, Autenrieth C, et al. Multimorbidity and successful aging: the population-based KORA-age study. Z Gerontol Geriatr. 2011;44(Suppl 54).
20.
go back to reference Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56.CrossRefPubMed Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56.CrossRefPubMed
22.
go back to reference Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRefPubMed
23.
go back to reference Chaudhry S, Jin L, Meltzer D. Use of a self-report-generated Charlson Comorbidity index for predicting mortality. Med Care. 2005;43:607–15.CrossRefPubMed Chaudhry S, Jin L, Meltzer D. Use of a self-report-generated Charlson Comorbidity index for predicting mortality. Med Care. 2005;43:607–15.CrossRefPubMed
24.
go back to reference Skjelbakken T, Langbakk B, Dahl IMS, Löchen ML. Haemoglobin and anaemia in a gender perspective: the Tromsø Study. Eur J Haematol. 2005;74:381–8.CrossRefPubMed Skjelbakken T, Langbakk B, Dahl IMS, Löchen ML. Haemoglobin and anaemia in a gender perspective: the Tromsø Study. Eur J Haematol. 2005;74:381–8.CrossRefPubMed
25.
go back to reference Cheng MH, Chang SF. Frailty as a risk factor for falls among community dwelling people: evidence from a meta-analysis. J Nurs Scholarsh. 2017; doi:10.1111/jnu.12322. Cheng MH, Chang SF. Frailty as a risk factor for falls among community dwelling people: evidence from a meta-analysis. J Nurs Scholarsh. 2017; doi:10.​1111/​jnu.​12322.
26.
go back to reference Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21:658–68.CrossRefPubMed Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21:658–68.CrossRefPubMed
27.
go back to reference Herndon JG, Helmick CG, Sattin RW, Stevens JA, DeVito C, Wingo PA. Chronic medical conditions and risk of fall injury events at home in older adults. J Am Geriatr Soc. 1997;45:739–43.CrossRefPubMed Herndon JG, Helmick CG, Sattin RW, Stevens JA, DeVito C, Wingo PA. Chronic medical conditions and risk of fall injury events at home in older adults. J Am Geriatr Soc. 1997;45:739–43.CrossRefPubMed
28.
go back to reference Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59:M255–63.CrossRef Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59:M255–63.CrossRef
29.
go back to reference Bergland A. Fall risk factors in community-dwelling elderly people. Nor J Epidemiol. 2012;22:151–64.CrossRef Bergland A. Fall risk factors in community-dwelling elderly people. Nor J Epidemiol. 2012;22:151–64.CrossRef
30.
go back to reference Jørgensen L, Skjelbakken T, Løchen ML, Ahmed L, Bjørnerem Å, Joakimsen R, Jacobsen BK. Anemia and the risk of non-vertebral fractures: the Tromsø Study. Osteoporos Int. 2010;21:1761–8.CrossRefPubMed Jørgensen L, Skjelbakken T, Løchen ML, Ahmed L, Bjørnerem Å, Joakimsen R, Jacobsen BK. Anemia and the risk of non-vertebral fractures: the Tromsø Study. Osteoporos Int. 2010;21:1761–8.CrossRefPubMed
31.
go back to reference Bergland A, Jarnlo GB, Laake K. Predictors of falls in the elderly by location. Aging Clin Exp Res. 2003;15:43–50.CrossRefPubMed Bergland A, Jarnlo GB, Laake K. Predictors of falls in the elderly by location. Aging Clin Exp Res. 2003;15:43–50.CrossRefPubMed
Metadata
Title
The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Tromsø Study 2001-02: a replication study
Authors
Laila Arnesdatter Hopstock
Elisabeth Bøe Utne
Alexander Horsch
Tove Skjelbakken
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0689-8

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