Department of Primary Care Medicine, Faculty of Medicine and Defense Health, National Defense University of Malaysia, Kuala Lumpur 57000, Malaysia.
Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia.
Int J Environ Res Public Health. 2022 Apr 20;19(9):4983. doi: 10.3390/ijerph19094983.
There is limited evidence on the association of anemia with chronic diseases and disabilities among older persons in Malaysia. We assessed the prevalence of anemia and its associated factors among community-dwelling older persons.
This was a cross-sectional study using data from the nationwide National Health and Morbidity Survey 2015 (NHMS 2015) on the health of older adults conducted by the Institute for Public Health, National Institutes of Health, Malaysia. A two-stage stratified random-cluster sampling design was utilized. Data were collected on the sociodemographic profiles, non-communicable disease (NCD) comorbidities (hypertension, diabetes and hypercholesterolemia status) and disabilities among the older persons. Anemia was defined based on the World Health Organization's standards. A multivariable logistic regression analysis was used to assess the association of anemia with chronic diseases and disabilities.
The prevalence of anemia was 35.3% (95% CI: 33.1, 37.4) in the older persons. Chronic disease profiling showed that the prevalence rates of anemia among the older persons with diabetes, hypertension and hypercholesterolemia were 38.6%, 35.3% and 34.1%, respectively. In the multivariable analysis, persons aged 80 years and above (adjusted OR (aOR): 2.64; 95% CI: 2.00, 3.47), 70-79 years (aOR: 1.42; 95% CI: 1.21, 1.66), with diabetes (aOR: 1.30; 95% CI: 1.13, 1.51) and with disabilities in walking (aOR: 1.31; 95% CI: 1.11, 1.54) and self-care (aOR: 1.58; 95% CI: 1.22, 2.05) had higher odds of anemia compared to their respective reference categories. Among the persons with diabetes, the respondents aged 80 years and above (aOR: 2.48; 95% CI: 1.56, 3.94), 70-79 years old (aOR: 1.38; 95% CI: 1.08, 1.76) and with disabilities in vision (aOR: 1.29; 95% CI: 1.02, 1.63) and walking (aOR: 1.50; 95% CI: 1.18, 1.91) were more likely to be anemic. Furthermore, among the older persons without diabetes, persons aged 80 years and above (aOR: 2.89; 95% CI: 2.05, 4.07), 70-79 years old (aOR: 1.46; 95% CI: 1.19, 1.80) and with difficulty in self-care (aOR: 1.87; 95% CI: 1.30, 2.69) were more likely to be anemic.
The resilient predictors of developing anemia were advancing age and diabetes, based on our study. Anemia is significantly associated with walking and vision disabilities among older persons with diabetes and with self-care difficulties in those without diabetes. There is a need for future studies to evaluate strategies to prevent anemia among older adults in order to promote healthy aging.
马来西亚老年人中，有关贫血与慢性病和残疾之间关联的证据有限。我们评估了社区居住老年人中贫血的患病率及其相关因素。
这是一项横断面研究，使用了马来西亚国立卫生研究院公共卫生研究所进行的全国老年人健康状况国家健康和发病率调查 2015 年（NHMS 2015）的数据。采用两阶段分层随机聚类抽样设计。数据收集了老年人的社会人口统计学特征、非传染性疾病（高血压、糖尿病和高胆固醇血症状况）共病和残疾情况。根据世界卫生组织的标准定义了贫血。采用多变量逻辑回归分析评估贫血与慢性病和残疾之间的关联。
老年人中贫血的患病率为 35.3%（95%CI：33.1, 37.4）。慢性病特征显示，患有糖尿病、高血压和高胆固醇血症的老年人中贫血的患病率分别为 38.6%、35.3%和 34.1%。在多变量分析中，80 岁及以上的人（调整后的 OR（aOR）：2.64；95%CI：2.00, 3.47）、70-79 岁（aOR：1.42；95%CI：1.21, 1.66）、患有糖尿病（aOR：1.30；95%CI：1.13, 1.51）和行走困难（aOR：1.31；95%CI：1.11, 1.54）和自我护理困难（aOR：1.58；95%CI：1.22, 2.05）的人比各自的参考类别更有可能患有贫血。在患有糖尿病的人群中，80 岁及以上的人（aOR：2.48；95%CI：1.56, 3.94）、70-79 岁（aOR：1.38；95%CI：1.08, 1.76）和视力障碍（aOR：1.29；95%CI：1.02, 1.63）和行走困难（aOR：1.50；95%CI：1.18, 1.91）的人更容易贫血。此外，在没有糖尿病的老年人中，80 岁及以上的人（aOR：2.89；95%CI：2.05, 4.07）、70-79 岁（aOR：1.46；95%CI：1.19, 1.80）和自我护理困难（aOR：1.87；95%CI：1.30, 2.69）的人更容易贫血。
根据我们的研究，导致贫血的弹性预测因素是年龄的增长和糖尿病。贫血与患有糖尿病的老年人的行走和视力残疾以及无糖尿病老年人的自我护理困难显著相关。需要进一步研究评估预防老年人贫血的策略，以促进健康老龄化。
