TY - JOUR
T1 - The effects of single and a combination of determinants of anaemia in the very old
T2 - results from the TULIPS consortium
AU - Wang, Pin Chun
AU - Gussekloo, Jacobijn
AU - Arai, Yasumichi
AU - Abe, Yukiko
AU - Blom, Jeanet W.
AU - Duncan, Rachel
AU - Jagger, Carol
AU - Kerse, Ngaire
AU - Martin-Ruiz, Carmen
AU - Palapar, Leah
AU - den Elzen, Wendy P.J.
N1 - Funding Information:
This work was supported by Dutch Ministry of Health, Welfare and Sports for Leiden 85-plus Study; Health Research Council of New Zealand, Ngā Pae o te Māramatanga, Heart Foundation, Rotorua Energy Charitable Trust and Ministry of Health for LiLACS NZ; UK Medical Research Council and Biotechnology and Biological Sciences Research Council for Newcastle 85+ study; and Keio University Global research Institute for TOOTH. This work was supported by the following grant: Japan Society for the Promotion of Science [No. 21590775, 21330155] for TOOTH.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - Inflammation
KW - Iron deficiency
KW - Low haemoglobin levels
KW - Renal impairment
KW - Vitamin B12/folate deficiency
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U2 - 10.1186/s12877-021-02389-2
DO - 10.1186/s12877-021-02389-2
M3 - Article
C2 - 34372781
AN - SCOPUS:85112182023
SN - 1471-2318
VL - 21
JO - BMC Geriatrics
JF - BMC Geriatrics
IS - 1
M1 - 457
ER -