Impact of anemia and cardiovascular disease on frailty status of community-dwelling older women: The Women's Health and Aging Studies I and II
Impact of anemia and cardiovascular disease on frailty status of community-dwelling older women: The Women's Health and Aging Studies I and II
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DOI：
10.1093/gerona/60.6.729
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发表时间：
2005-06-01
影响因子：
5.1
通讯作者：
Fried, LP
中科院分区：
文献类型：
--
作者：
Chaves, PHM;Semba, RD;Fried, LP
背景老年虚弱综合征是一种易受残疾和死亡等不良后果影响的临床状态，其生理基础仍有待进一步研究。我们研究了血红蛋白（Hb）和最近验证的社区老年妇女虚弱程度之间的横截面关系，以及这种关系是否被心血管疾病（CVD）状态所改变。数据来自参与妇女健康和衰老研究I和II（巴尔的摩，MD，1992-1996）的70-80岁的已知虚弱状态和Hb >= 10 g/dL的妇女（n = 670）。Logistic回归分析用于建立虚弱和Hb之间的关系模型，调整人口统计学、主要慢性疾病以及生理和功能障碍。虚弱的患病率为14%。虚弱风险在最低Hb水平时最高，在中等正常Hb水平时最低（例如，13-14 g/dL）。轻度偏低和正常偏低的lib浓度与虚弱独立相关。与血红蛋白浓度等于13.5 g/dL相比，血红蛋白浓度等于11.5 g/dL和12 g/dL时，调整后的虚弱几率分别高出1.9倍（95%置信区间：1.1-3.4）和1.5倍（95%置信区间：1.0-2.1）。Hb水平和CVD状态与虚弱风险之间的乘法交互作用具有统计学显著性（p <0.05）。在社区居住的老年妇女中，轻度低和低正常Hb水平与虚弱风险增加独立相关。这种风险是协同修改的CVD的存在。这些结果表明，轻度贫血，甚至低正常血红蛋白水平是独立的，潜在的可改变的危险因素，在社区居住的老年人虚弱。
Background. The physiological basis of the geriatric syndrome of frailty, a clinical state of increased vulnerability to adverse outcomes such as disability and mortality, remains to be better characterized. We examined the cross-sectional relationship between hemoglobin (Hb) and a recently-validated measure of frailty in community-dwelling older women, and whether this relationship was modified by cardiovascular disease (CVD) status.Methods. Data were pooled from women 70-80 years old participating in the Women's Health and Aging Studies I and II (Baltimore, MD, 1992-1996) with known frailty status and Hb >= 10 g/dL (n = 670). Logistic regression was used to model the relationship between frailty and Hb, adjusting for demographics, major chronic diseases, and physiologic and functional impairments.Results. Prevalence of frailty was 14%. Frailty risk was highest at the lowest Hb levels, and lowest at mid-normal Hb levels (e.g., 13-14 g/dL). Mildly low and low-normal lib concentrations were independently associated with frailty. Compared to an Hb concentration equal to 13.5 g/dL, the adjusted odds of being frail were 1.9 (95% confidence interval: 1.1-3.4) and 1.5 (95% confidence interval: 1.0-2.1) times higher for Hb concentrations equal to 11.5 g/dL and 12 g/dL, respectively. A statistically significant (p < .05) multiplicative interaction between Hb level and CVD status with respect to frailty risk was observed.Conclusion. In community-dwelling older women, mildly low and low-normal Hb levels were independently associated with increased frailty risk. This risk was synergistically modified by the presence of CVD. These results suggest that mild anemia, and even low-normal Hb levels are independent, potentially modifiable risk factors for frailty in community-dwelling older adults.