Broghammer Simon, Gagesch Michael, Wieczorek Maud, Kressig Reto W, Manz Markus G, Orav E John, Bischoff-Ferrari Heike A
Department of Medical Oncology and Hematology, Comprehensive Cancer Center Zurich, University Hospital Zurich and University of Zurich, University of Zurich, Zurich, Switzerland.
Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland.
Ann Hematol. 2025 Sep 8. doi: 10.1007/s00277-025-06558-w.
While frailty and anemia are prevalent conditions in aging linked to adverse outcomes, their relationship remains understudied in generally healthy older adults. We conducted a post-hoc observational study among all participants of DO-HEALTH, the largest European clinical trial designed to support healthy aging. Our analysis examined whether baseline hemoglobin levels and anemia are associated with being at least pre-frail at baseline and any yearly follow-up time point over three years. Frailty status was assessed by the Fried frailty phenotype at baseline and at each annual follow-up visit. Participants were considered at least pre-frail by the presence of any frailty domain (fatigue, unintentional weight loss, slowness, weakness, low activity). For both hemoglobin levels and anemia as predictors, we used regression models based on generalized estimating equations controlling for potential confounders. In total, 2,123 of 2,157 participants had available frailty status and hemoglobin levels at baseline and were included in the analysis (mean age 74.9 years; 61.7% women). At baseline, 46.4% (n = 986) were at least pre-frail, while the mean hemoglobin level was 139.7 g/L (SD 12.5), and 6.7% (n = 141) had anemia. In our multivariate prospective analysis, each 10-g/L decrease in baseline hemoglobin levels was associated with 8% higher odds of pre-frailty (adjusted Odds Ratio [aOR] 1.08, 95%CI 1.01-1.16, p 0.02), and baseline anemia was associated with 39% higher odds of pre-frailty over three years (aOR = 1.39, 95%CI 1.02-1.88, p 0.03). In conclusion, our results provide novel insights into the association between hemoglobin levels, anemia, and pre-frailty in generally healthy and active older adults.
虽然衰弱和贫血是与不良后果相关的衰老常见状况，但在总体健康的老年人中，它们之间的关系仍未得到充分研究。我们在DO-HEALTH的所有参与者中进行了一项事后观察性研究，DO-HEALTH是欧洲最大的旨在支持健康衰老的临床试验。我们的分析考察了基线血红蛋白水平和贫血是否与基线时至少处于衰弱前期以及三年中任何年度随访时间点相关。在基线和每次年度随访时，通过Fried衰弱表型评估衰弱状态。若存在任何衰弱领域（疲劳、非故意体重减轻、行动迟缓、虚弱、活动量低），则参与者被视为至少处于衰弱前期。对于血红蛋白水平和贫血作为预测因素，我们使用基于广义估计方程的回归模型来控制潜在混杂因素。在2157名参与者中，共有2123人在基线时具有可用的衰弱状态和血红蛋白水平，并被纳入分析（平均年龄74.9岁；61.7%为女性）。在基线时，46.4%（n = 986）至少处于衰弱前期，而平均血红蛋白水平为139.7 g/L（标准差12.5），6.7%（n = 141）患有贫血。在我们的多变量前瞻性分析中，基线血红蛋白水平每降低10 g/L，衰弱前期的几率就会高出8%（调整后的优势比[aOR]为1.08，95%置信区间为1.01 - 1.16，p = 0.02），并且基线贫血与三年中衰弱前期的几率高出39%相关（aOR = 1.39，95%置信区间为1.02 - 1.88，p = 0.03）。总之，我们的结果为总体健康且活跃的老年人中血红蛋白水平、贫血与衰弱前期之间的关联提供了新的见解。
