贫血和动力不足对老年人死亡风险的综合影响：来自 ELSA 队列研究的 10 年证据。

The combined effect of anemia and dynapenia on mortality risk in older adults: 10-Year evidence from the ELSA cohort study.

机构信息

Post-graduate Program in Physical Therapy, Federal University of Sao Carlos. Rodovia Washington Luís, km 235, SP-310, 13565-905, Sao Carlos, Sao Paulo, Brazil.

Department of Epidemiology and Public Health, University College London. Gower Street, London, WC1E 6BT, United Kingdom; Post-graduate Program in Rehabilitation Sciences. Federal University of Santa Catarina. Pedro João Pereira Street, 150, Mato Alto, 88905-120, Araranguá, Santa Catarina, Brazil.

出版信息

Arch Gerontol Geriatr. 2022 Sep-Oct;102:104739. doi: 10.1016/j.archger.2022.104739. Epub 2022 Jun 1.

DOI:10.1016/j.archger.2022.104739

PMID:35675739

Abstract

BACKGROUND/OBJECTIVE: Anemia and dynapenia can occur simultaneously. Separately, both conditions increase the mortality risk with advancing age. However, there is no epidemiological evidence on the combined effect of these conditions on mortality in older adults. We investigated whether combined anemia and dynapenia increase the mortality risk, and whether there are gender differences.

METHODS

A 10-year follow-up study was conducted involving 5,310 older adults from the English Longitudinal Study of Ageing (ELSA). According to the diagnosis of anemia (hemoglobin concentration < 13.0 g/dL in men and < 12.0 g/dL in women) and dynapenia (grip strength < 26 kg for men and < 16 kg for women), individuals at baseline were categorized as "non-anemic/non-dynapenic", "dynapenic", "anemic" and "anemic/dynapenic". The outcome was all-cause mortality during the follow-up period.

RESULTS

A total of 984 deaths were computed during the follow-up (63.7% in non-anemic/non-dynapenic, 22.8% in dynapenic, 7.5% in anemic and 6.0% in anemic/dynapenic). Adjusted Cox proportional hazard models stratified by sex showed that anemia and dynapenia combined was associated with an increased mortality risk in men (HR: 1.64; 95% IC 1.08 - 2.50) and women (HR: 2.17; 95% CI 1.44 - 3.26). Anemia in men (HR: 1.68; 95% CI 1.22 - 2.32) and dynapenia in women (HR: 1.37; 95% CI 1.09 - 1.72) were also risk factors for mortality.

CONCLUSIONS

The coexistence of anemia and dynapenia increases the mortality risk, highlighting the need for early identification, prevention, and treatment of these conditions to reduce their complications and the mortality risk.

摘要

背景/目的：贫血和肌肉减少症可能同时发生。单独来看，这两种情况都会随着年龄的增长增加死亡风险。然而，目前尚无关于这些情况在老年人中对死亡率的综合影响的流行病学证据。我们研究了同时患有贫血和肌肉减少症是否会增加死亡风险，以及是否存在性别差异。

方法

对来自英国老龄化纵向研究（ELSA）的 5310 名老年人进行了为期 10 年的随访研究。根据贫血（男性血红蛋白浓度<13.0 g/dL，女性<12.0 g/dL）和肌肉减少症（握力男性<26 kg，女性<16 kg）的诊断，基线时个体被分为“非贫血/非肌肉减少症”、“肌肉减少症”、“贫血”和“贫血/肌肉减少症”。主要结局为随访期间的全因死亡率。

结果

在随访期间共发生 984 例死亡（非贫血/非肌肉减少症者占 63.7%，肌肉减少症者占 22.8%，贫血者占 7.5%，贫血/肌肉减少症者占 6.0%）。按性别分层的调整后的 Cox 比例风险模型显示，男性（HR：1.64；95%CI 1.08-2.50）和女性（HR：2.17；95%CI 1.44-3.26）中贫血和肌肉减少症并存与死亡率增加相关。男性贫血（HR：1.68；95%CI 1.22-2.32）和女性肌肉减少症（HR：1.37；95%CI 1.09-1.72）也是死亡的危险因素。