Abstract
BackgroundOver 10% of adults aged ≥65 years have anemia, as defined by the World Health Organization (WHO). As the timed up and go (TUG) test is one of the most widely used tests of mobility, this study investigated whether anemia was associated with mobility capacity assessed using the TUG test in older adults.MethodsSubjects belonging to the Korean National Health Insurance Service-National Health Screening Cohort of the National Health Information Database were reviewed. Subjects were included if they had completed the TUG test as part of the National Screening Program for Transitional Ages in Korea. An abnormal TUG test result was defined as a time of ≥10 s and anemia was defined according to the WHO criteria as a hemoglobin (Hb) concentration of < 13.0 g/dL in men and < 12.0 g/dL in women. The association between anemia and TUG test results was evaluated using four multiple logistic regression models with different levels of adjustment. Stratified analysis according to risk factors was performed.ResultsThe 81,473 subjects included 41,063 (50.4%) women and 40,410 (49.6%) men. Mean TUG time was 8.44 ± 3.08 s, and abnormal TUG test results were observed in 22,138 (27.2%) subjects. Mean Hb concentration was 13.72 ± 1.41 g/dL, and 10,237 (12.6%) subjects had anemia. U-shaped associations between Hb concentration and TUG test results were observed in both sexes. Subjects with anemia were 19% more likely to have abnormal TUG test results, according to the fully adjusted model (adjusted odds ratio: 1.192, 95% confidence interval: 1.137–1.247). Similar results were observed for both sexes. Stratified analysis showed that subjects with anemia were more likely to have abnormal TUG test results regardless of risk factors.ConclusionsIndividuals with anemia are more likely to have abnormal TUG test results, regardless of risk factors, than individuals without anemia. U-shaped relationships between Hb concentrations and TUG test results were observed in both sexes, although the optimal Hb concentration differed between men and women.
Highlights
Over 10% of adults aged ≥65 years have anemia, as defined by the World Health Organization (WHO)
Of the potentially eligible participants, we excluded 429, 611 participants who did not participate in the National Screening Program for Transitional Ages (NSPTA) for 66-year-olds
Of the remaining 86,256 participants, we excluded those with disabilities at baseline, those who were registered in the Korean National Disability Registry (KNDR) (n = 1255), and those with impairments in activities of daily living (ADL) (n = 3448)
Summary
Over 10% of adults aged ≥65 years have anemia, as defined by the World Health Organization (WHO). As the timed up and go (TUG) test is one of the most widely used tests of mobility, this study investigated whether anemia was associated with mobility capacity assessed using the TUG test in older adults. Anemia is a common condition in older adults and is due to multiple factors. Anemia in older adults is associated with various negative health outcomes, including reduced quality of life [3,4,5], depressive mood and fatigue [4, 5], falls [6, 7], frailty [3, 8], impairment in ADL [4, 9,10,11], cognitive impairment [10], and increased mortality [12, 13]. Studies assessing the association between functional decline in mobility and anemia in older adults have shown that anemia is associated with impaired standing balance [4, 14, 15], slower gait speed [4, 14,15,16], slower chair standing [4, 14, 15], decreased muscle strength including, handgrip and knee extensor strengths [4, 15], and multidimensional loss of function [17]
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