Low Hemoglobin Levels and Recurrent Falls in U.S. Men and Women: Prospective Findings from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort

• Type of Material: Article
• Authors: Barrett Bowling, Emory University; Paul Muntner, University of Alabama Birmingham; Brian D. Bradbury, Amgen Inc.; Ryan D. Kilpatrick, Amgen Inc.; John J. Isitt, Amgen Inc.; Amy H. Warriner, University of Alabama Birmingham; Jeffrey R. Curtis, University of Alabama Birmingham; Suzanne Judd, University of Alabama Birmingham; Cynthia J. Brown, Department of Veteran Affairs Medical Center; Richard M. Allman, Department of Veteran Affairs Medical Center; David Gene Warnock, University of Alabama Birmingham; William McClellan, Emory University
• Language: English
• Date: 2013-06-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Lippincott Williams and Wilkins.
• Final Published Version (URL): http://dx.doi.org/10.1097/MAJ.0b013e3182638364
• Title of Journal or Parent Work: American Journal of the Medical Sciences
• ISSN: 0002-9629
• Volume: 345
• Issue: 6
• Start Page: 446
• End Page: 454
• Grant/Funding Information: REGARDS was supported by a cooperative agreement (U01 NS041588) with the National Institute of Neurological Disorders and Stroke; and Amgen; and in part by an Arthritis Foundation grant to JRC.; Some of the investigators receive support from the National Institutes of Health (JRC: AR053351); and the Deep South Resource Center for Minority Aging Research, from the National Institute on Aging (RMA: P30AG031054).; Additional support was provided through the Birmingham/Atlanta GRECC Special Fellowship in Advanced Geriatrics; and John A. Hartford Foundation/Southeast Center of Excellence in Geriatric Medicine to CBB.
• Keywords: Science & Technology; Gender; Hemoglobin; COGNITIVE IMPAIRMENT; HEALTH; RISK-FACTORS; ELDERLY-PEOPLE; OLDER WOMEN; General & Internal Medicine; INJURIOUS FALLS; Falls; Medicine, General & Internal; ANEMIA; Life Sciences & Biomedicine; LONG-TERM-CARE
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

BACKGROUND: There are few data available on low hemoglobin and incident falls in the general U.S. population. METHODS: Of 30,239 black and white U.S. adults ≥45 years in the population-based REasons for Geographic And Racial Differences in Stroke study, 16,782 had hemoglobin measured at baseline and follow-up data on falls. Hemoglobin was categorized by 1.0 g/dL increments relative to the World Health Organization anemia threshold (<13.0 g/dL for men, <12.0 g/dL for women). Recurrent falls (≥2 falls in the 6 months after baseline) were assessed during a telephone interview. RESULTS: Recurrent falls occurred in 3.9% of men and 4.8% of women. Compared with those with a hemoglobin level 1 to 2 g/dL above the anemia cut-off, multivariable adjusted odds ratios (95% confidence intervals) for recurrent falls associated with hemoglobin levels ≥3, 2 to <3 and 0 to 1 g/dL above the cut-off point, and 0 to <1 and ≥1 g/dL below the cut-off point were 0.73 (0.45-1.19), 0.84 (0.57-1.24), 1.29 (0.88-1.90), 1.32 (0.0.80-1.2.18) and 2.12 (1.23-3.63), respectively, among men (linear trend P < 0.001), and 1.59 (1.10-2.3), 1.24 (0.95-1.62), 1.42(1.11-1.81), 1.28 (0.91-1.80) and 1.76 (1.13-2.74), respectively, among women (linear trend P = 0.45; quadratic trend P = 0.016). CONCLUSIONS: Among men, lower hemoglobin levels were associated with an increased risk for recurrent falls. Although our findings suggest an increased risk for recurrent falls at both lower and higher hemoglobin levels among women, these findings should be confirmed in subsequent studies.