The effects of single and a combination of determinants of anaemia in the very old: results from the TULIPS consortium

Pin Chun Wang, Jacobijn Gussekloo, Yasumichi Arai, Yukiko Abe, Jeanet W. Blom, Rachel Duncan, Carol Jagger, Ngaire Kerse, Carmen Martin-Ruiz, Leah Palapar, Wendy P.J. den Elzen

Research output: Contribution to journalArticlepeer-review

Abstract

Background and objectives: Nutritional deficiencies, renal impairment and chronic inflammation are commonly mentioned determinants of anaemia. The aim of this study was to investigate the effects of these determinants, singly and in combination, on anaemia in the very old. Method: The TULIPS Consortium consists of four population-based studies in oldest-old individuals: Leiden 85-plus Study, LiLACS NZ, Newcastle 85+ study, and TOOTH. Five selected determinants (iron, vitamin B12, and folate deficiency; low estimated glomerular filtration rate (eGFR); and high C-reactive protein (CRP)) were summed. This sum score was used to investigate the association with the presence and onset of anaemia (WHO definition). The individual study results were pooled using random-effects models. Results: In the 2216 participants (59% female, 30% anaemia) at baseline, iron deficiency, low eGFR and high CRP were individually associated with the presence of anaemia. Low eGFR and high CRP were individually associated with the onset of anaemia. In the cross-sectional analyses, an increase per additional determinant (adjusted OR 2.10 (95% CI 1.85–2.38)) and a combination of ≥2 determinants (OR 3.44 (95% CI 2.70–4.38)) were associated with the presence of anaemia. In the prospective analyses, an increase per additional determinant (adjusted HR 1.46 (95% CI 1.24–1.71)) and the presence of ≥2 determinants (HR 1.95 (95% CI 1.40–2.71)) were associated with the onset of anaemia. Conclusion: Very old adults with a combination of determinants of anaemia have a higher risk of having, and of developing, anaemia. Further research is recommended to explore causality and clinical relevance.

Original languageEnglish
Article number457
JournalBMC Geriatrics
Volume21
Issue number1
DOIs
Publication statusPublished - 2021 Dec
Externally publishedYes

Keywords

  • Inflammation
  • Iron deficiency
  • Low haemoglobin levels
  • Renal impairment
  • Vitamin B12/folate deficiency

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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