Anemia Linked to Physical Decline in Elderly

Researchers don't yet know if treatments might reverse the problem

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FRIDAY, July 25, 2003 (HealthDayNews) -- When you're over 70, having anemia can double your chances that performing routine physical tasks will become daunting.

That's the conclusion of a new study appearing in the Aug. 1 issue of the American Journal of Medicine.

"People with anemia had a higher risk to show a decline in physical performance," says study co-author Dr. Brenda Penninx, an associate professor of internal medicine and geriatrics at the Stricht Center for Aging at Wake Forest University School of Medicine.

Even older people with borderline anemia had a higher risk of physical decline, the study found.

Anemia is a disorder of the red blood cells that reduces their ability to carry oxygen throughout the body. It has a number of causes, including a lack of iron in the diet, vitamin deficiencies, medications, or an underlying disease such as cancer.

For four years, the researchers followed a group of 1,146 people over the age of 71. All of the participants lived in Iowa. Nearly 70 percent of the group was female.

At the start of the study, and four years later, the participants were asked to perform three routine physical tasks: walking a short, timed distance, rising from a chair, and standing in a balanced position. The researchers also collected blood samples and gathered routine health information, such as smoking status, weight, and blood pressure.

Six percent of the volunteers had anemia and 15 percent had borderline anemia. Penninx says she believes most of the participants were unaware of their anemia.

After four years, two-thirds of the participants showed declines in their ability to perform the simple physical tasks. Thirty percent of the volunteers showed significant declines in their physical ability.

Those with anemia had a 2.1 times greater risk of having a substantial physical decline. Those with borderline anemia had a 1.5 times greater risk.

Penninx says there are probably several reasons why anemia is associated with physical decline. "Anemia is associated with fatigue, low energy levels, and weakness, which are all conditions that will affect your ability to function," she says.

Another reason may be that because of the anemia, the muscles of elderly people may simply not receive enough oxygen to function properly.

"I think this study is an interesting first step of research that needs to come," says Dr. Linda Carmosino, a hematologist/oncologist at Nassau University Medical Center in East Meadow, N.Y. "The next step would be to see if treating these patients made a difference in their function."

Carmosino says it's also important to realize that anemia is often a sign of underlying disease in the elderly, such as cancer, and that it could be the cancer that is affecting function more than the anemia.

Because anemia can be a sign of other medical problems, Carmosino says it's important to find the cause of the anemia and treat it. If no cause can be found, which is sometimes the case, she says people are sometimes treated with erythropotein, a hormone that stimulates red blood cell production. However, she's not convinced this could reverse the physical declines seen in the study.

Penninx says older people shouldn't assume that fatigue or physical decline is a normal part of aging, and they should talk with their doctor about such symptoms.

More information

To learn more about anemia, go to the American Academy of Family Physicians or to the National Library of Medicine.

SOURCES: Brenda Penninx, Ph.D., professor, internal medicine and geriatrics, Stricht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, N.C.; Linda Carmosino, M.D., hematologist/oncologist, Nassau University Medical Center, East Meadow, N.Y.; Aug. 1, 2003, American Journal of Medicine
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