JAMDA
Volume 8, Issue 3, Supplement 2 , Pages e9-e15 , March 2007

Anemia Increases Risk for Falls in Hospitalized Older Adults: An Evaluation of Falls in 362 Hospitalized, Ambulatory, Long-Term Care, and Community Patients

This work was presented, in part, at the Annual Meeting of the American Geriatrics Society Annual Meeting in 2005. Dharmarajan TS, Avula S, Jayakrishnan L, Jospeh P, Talamati J, Karbasian M. Norkus EP. Mild anemia increases the risk of falls in hospitalized older adults. J Am Geriatr Soc 2005;53:S94.

  • T.S. Dharmarajan, MD, FACP, AGSF

      Affiliations

    • Department of Medicine, Our Lady of Mercy Medical Center, Bronx, NY
    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • Corresponding Author InformationAddress correspondence to T.S. Dharmarajan, MD, FACP, AGSF, 31 Pheasant Run, Scarsdale, NY 10583.
    • ,
  • Sai Avula, MD

      Affiliations

    • Division of Geriatrics, Our Lady of Mercy Medical Center, Bronx, NY
    • ,
  • Edward P. Norkus, PhD, FACN

      Affiliations

    • Department of Medical Research, University Hospital of New York Medical College, Valhalla, NY.

References 

  1. World Health Organization. Nutritional Anemias. Geneva, Switzerland: WHO; 1968;Technical Report Series No. 405
  2. Beard JL, Ashraf MH, Smiciklas-Wright H. Iron nutrition in the elderly. In:  Watson RR editors. Handbook of Nutrition in the Aged. 2nd ed.. Boca Raton, FL: CRC Press, Inc; 1994;p. 393–414
  3. Hollowell JG, Van Assendelft OW, Gunter EW, et al. National Center for Health Statistics Hematological and iron-related analyses—Reference data for persons aged 1 year and over; United States, 1988–1994. Vital Health Stat. 2005;11(247):
  4. Looker AC, Cogswell ME, Gunter EW. Iron deficiency—United States, 1999–2000. MMWR. 2002;51:897–899
  5. Guralnik JM, Eisenstaedt RS, Ferrucci L, et al. Prevalence of anemia in persons 65 years and older in the United States: Evidence for a high rate of unexplained anemia. Blood. 2004;104:2263–2268
  6. Balducci L. Epidemiology of anemia in the elderly: Information on diagnostic evaluation. J Am Geriatr Soc. 2003;51:S2–S9
  7. Schrier SL. It’s tough to be old and anemic. Blood. 2004;104:2214–2215
  8. Chaves PHM, Ashar B, Guralnik JM, et al. Looking at the relationship between hemoglobin concentration and prevalent mobility difficulty in older women (Should the criteria currently used to define anemia in older people be reevaluated?). J Am Geriatr Soc. 2002;50:1257–1264
  9. Penninx BW, Guralnik JM, Onder G, et al. Anemia and decline in physical performance among older persons. Am J Med. 2003;115:104–110
  10. Lawlor DA, Patel R, Ebrahim S. Association between falls in elderly women and chronic diseases and drug use: Cross sectional study. BMJ. 2003;327:712–717
  11. Dharmarajan TS, Norkus EP. Mild anemia and the risk of falls in older adults from nursing homes and the community. J Am Med Dir Assoc. 2004;5:395–400
  12. Bloem BR, Steijns JA, Smits-Engelsman BC. An update on falls. Curr Opin Neurol. 2003;16:15–26
  13. King MB, Tinetti ME. A multifactorial approach to reducing injurious falls. Clin Geriatr Med. 1996;12:745–759
  14. Chang JT, Morton SC, Rubestein LZ, et al. Interventions for the prevention of falls in older adults: Systematic review and meta-analysis of randomized clinical trials. BMJ. 2004;328:680–683
  15. Prudham D, Evans JG. Factors associated with falls in the elderly: A community study. Age Ageing. 1981;10:141–146
  16. Tinetti ME. Factors associated with serious injury during falls by ambulatory nursing home residents. J Am Geriatr Soc. 1987;35:644–648
  17. Stalenhoef PA, Diederiks JP, Knottnerus JA, et al. A risk model for the prediction of recurrent falls in community-dwelling elderly: A prospective cohort study. J Clin Epidemiol. 2002;55:1088–1094
  18. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–1707
  19. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health. 1992;82:1020–1023
  20. Marks R, Allegrante JP, Ronald MC, et al. Hip fractures among the elderly: Causes, consequences and control. Ageing Res Rev. 2003;2:57–93
  21. Cooper C, Campion G, Melton LJI. Hip fractures in the elderly: A world-wide projection. Osteoporos Int. 1992;2:285–289
  22. Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. J Forensic Sci. 1996;41:733–746
  23. Herndon JG, Helmick CG, Sattin RW, et al. Chronic medical conditions and risk of fall injury events at home in older adults. J Am Geriatr Soc. 1997;45:739–743
  24. Robertson MC, Campbell AJ, Gardner MM, et al. Preventing injuries in older people by preventing falls: A meta-analysis of individual-level data. J Am Geriatr Soc. 2002;50:905–911
  25. Moreland J, Richardson J, Chan DH, et al. Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology. 2003;49:93–116
  26. Balducci L. Epidemiology of anemia in the elderly: Information on diagnostic evaluation. J Am Geriatr Soc. 2003;51(Suppl):S2–S9
  27. Aapro MS, Cella D, Zagari M. Age, anemia, and fatigue. Semin Oncol. 2002;29:55–59
  28. Eckardt K-U. Cardiovascular consequences of renal anaemia and erythropoietin therapy. Nephrol Dial Transplant. 1999;14:1317–1323
  29. Levin A. Clinical epidemiology of cardiovascular disease in chronic kidney disease prior to dialysis. Semin Dial. 2003;16:101–105
  30. de Rekeneire N, Visser M, Peila R, et al. Is a fall just a fall: Correlates of falling in healthy older persons (The Health, Aging and Body Composition Study). J Am Geriatr Soc. 2003;51:841–846
  31. Cesari M, Landi F, Torre S, et al. Prevalence and risk factors for falls in an older community-dwelling population. J Gerontol A Biol Sci Med Sci. 2002;57:M722–M726
  32. Ryynanen OP. Health, functional capacity, health behaviour, psychosocial factors and falling in old age. Public Health. 1994;108:99–110
  33. Smith RG. Fall-contributing adverse effects of the most frequently prescribed drugs. J Am Podiatr Med Assoc. 2003;93:42–50
  34. Gillespie L. Preventing falls in elderly people [editorial]. BMJ. 2004;328:653–654
  35. Vassallo M, Vignaraja R, Sharma JC, et al. The effect of changing practice on fall prevention in a rehabilitative hospital: The hospital injury prevention study. J Am Geriatr Soc. 2004;52:335–339
  36. Kenny RA, Rubenstein LZ, Martin FC, et al. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49:664–672
  37. Vassallo M, Stockdale R, Sharma JC, et al. A comparative study of the use of four fall risk assessment tools on acute medical wards. J Am Geriatr Soc. 2005;53:1034–1038
  38. Feinsod AM, Capezutti EA, Felix V. Reducing falls risk in long-term care residents through interdisciplinary approach. Annals of Long Term Care. 2005;13:24–33
  39. Dharmarajan TS, Avula S, Jospeh P, et al. Falls in ambulatory community older adults are linked to anemia and nutritional status. [abstract] J Nutr Health Aging. 2005;9:136

 This study did not receive external funding. This study was internally funded as part of the Geriatric Medicine Fellowship program.

PII: S1525-8610(06)00610-4

doi: 10.1016/j.jamda.2006.12.015

JAMDA
Volume 8, Issue 3, Supplement 2 , Pages e9-e15 , March 2007

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