Anemia and Hemoglobin Levels in Older Persons: Relationship with Age, Gender, and Health Status

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Abstract
Objective To determine the relationship of hemoglobin levels and anemia with age and health status in older adults. Design Survey. Setting Community. Participants and Methods Hematologic tests were obtained from 3,946 adults aged ≥71 years in three communities (East Boston, MA; Iowa and Washington counties, IA; and New Haven, CT). Results Hemoglobin level was inversely associated with age, although this was more pronounced in men than in women. The proportion anemic was equal for men and women aged 71–74 years (8.6%) and increased differentially with age, reaching 41% and 21% for men and women aged ≥90 years, respectively. Hemoglobin and anemia were independently associated with age, race, body‐mass index, smoking, cancer, hospitalization, renal insufficiency, and hypoalbuminemia. The adjusted relative odds of anemia for a 5‐year increase in age was 1.5 (95% confidence interval [CI] 1.3–1.8) for men and 1.2 (95% CI 1.1–1.4) for women. Conclusions Age is significantly associated with both hemoglobin levels and anemia, with a stronger effect in men compared with women, even after simultaneously adjusting for demographic characteristics and health status. The decline of hemoglobin and concomitant increased anemia with age is not necessarily a result of “normal aging” so the detection of anemia in an older person should prompt appropriate clinical attention.