Five‐Year Survival of Older People with Anemia: Variation with Hemoglobin Concentration

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Abstract
OBJECTIVES: To investigate the significance of low hemoglobin concentration and longevity in older people. DESIGN: Randomized prospective study. SETTING: Nursing home and geriatric hospital ward in a metropolitan welfare center. PARTICIPANTS: Apparently stable older residents from 1990 to 1996. MEASUREMENTS: Survival rates were estimated by statistical analysis. Sixty‐three older subjects with low hemoglobin (HbP = .0078). FSR was 67% in normal controls and 48% in anemic individuals age 70 to 79. The figures for individuals age 80 to 89 were 62% and 41%, respectively, and for individuals age 90 to 99 were 25% and 13%, respectively, the survival rate significantly decreasing with age in both groups (P < .001). FSR with severe anemia (Hb≤ 8.9g/dl) was 0% in males, and 27% in females. Values for moderate anemia (9.0g/dl to 10.9g/dl) were 25% and 51%, respectively, for normal hemoglobin (11.0g/dl to 12.9g/dl) were 44% and 61%, respectively, and for high hemoglobin (13.0g/dl≤Hb) were 50% and 70%, respectively. Advanced carcinomas were often detected at autopsy in anemic individuals. No death by cancer occurred in normal controls. CONCLUSION: Low hemoglobin concentration predicts early death in nursing home residents. Anemia‐associated conditions that might be life‐threatening risks in older people require further investigation.