Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-17T00:17:50.888Z Has data issue: false hasContentIssue false
  • English
  • Français

Anemia and dementia among the elderly: the São Paulo Ageing & Health Study

Published online by Cambridge University Press:  09 September 2011

Itamar S. Santos ,
Márcia Scazufca ,
Paulo A. Lotufo ,
Paulo R. Menezes  and
Isabela M. Benseñor
Itamar S. Santos*
Affiliation:
University Hospital of the University of São Paulo, Internal Medicine Division, São Paulo, Brazil
Márcia Scazufca
Affiliation:
University of São Paulo Medical School, Department of Psychiatry, São Paulo, Brazil Clinics Hospital of the University of São Paulo Medical School, Psychiatry Division, São Paulo, Brazil
Paulo A. Lotufo
Affiliation:
University Hospital of the University of São Paulo, Internal Medicine Division, São Paulo, Brazil University of São Paulo Medical School, Department of Internal Medicine, São Paulo, Brazil
Paulo R. Menezes
Affiliation:
University of São Paulo Medical School, Department of Preventive and Social Medicine, São Paulo, Brazil
Isabela M. Benseñor
Affiliation:
University Hospital of the University of São Paulo, Internal Medicine Division, São Paulo, Brazil University of São Paulo Medical School, Department of Internal Medicine, São Paulo, Brazil
*
Correspondence should be addressed to: Itamar S. Santos, Hospital Universitário – USP, 2565, Professor Lineu Prestes Ave., 3o andar – Centro de Pesquisa Clínica, São Paulo, Brazil. Phone: +55-11-3091-9300; Fax: +55-11-3091-4271.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the São Paulo Ageing & Health Study to address the relationship between anemia and dementia.

Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, São Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively.

Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17–3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76–2.33, p = 0.32). Further multivariate adjustment did not change the results.

Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from São Paulo.

Keywords

epidemiologydeveloping countrymental state examinationmedical comorbidity
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 74 - 81
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Atti, A. R., Palmer, K., Volpato, S., Zuliani, G., Winblad, B. and Fratiglioni, L. (2006). Anaemia increases the risk of dementia in cognitively intact elderly. Neurobiology of Aging, 27, 278–284.CrossRefGoogle ScholarPubMed
Beard, C. M., Kokmen, E., O'Brian, P. C., Anía, B. J. and Melton, J. (1997). Risk of Alzheimer's disease among elderly patients with anemia: population-based investigations in Olmsted County, Minnesota. Annals of Epidemiology, 7, 219–224.CrossRefGoogle ScholarPubMed
Benseñor, I. M., Lotufo, P. A., Menezes, P. R. and Scazufca, M. (2010). Subclinical hyperthyroidism and dementia: the Sao Paulo Ageing & Health Study (SPAH). BMC Public Health, 10, 298. Available at http://www.biomedcentral.com/1471-2458/10/298; last accessed 16 May 2011. doi:10.1186/1471-2458-10-298CrossRefGoogle Scholar
Brooker, S. et al. (2007). Age-related changes in hookworm infection anemia and iron deficiency in area of high Necator Americanus hookworm transmission in south-eastern Brazil. Transactions of the Royal Society of Tropical Medicine and Hygiene, 101, 146–154.CrossRefGoogle ScholarPubMed
Copeland, J. R., Dewey, M. E. and Griffiths-Jones, H. M. (1986). A computerized psychiatry diagnostic system and the case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.CrossRefGoogle Scholar
Culleton, B. F., Manns, B. J., Zhang, J., Tonelli, M., Klarenbach, S. and Hemmelgarn, B. R. (2006). Impact of anemia on hospitalization and mortality in older adults. Blood, 107, 3841–3846.CrossRefGoogle ScholarPubMed
Da Silveira, A.D. et al. (2008). Association of anemia with clinical outcomes in stable coronary heart disease. Coronary Artery Disease, 19, 21–26.CrossRefGoogle Scholar
De Benoist, B., McLean, E., Egll, I. and Cogswell, M. (2008). Worldwide Prevalence of Anaemia 1993–2005. Available at http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/en/ida_assessment_prevention_control.pdf; last accessed 11 March 2011.Google Scholar
Deal, J. A., Carlson, M. C., Xue, Q-L., Fried, L. P. and Chaves, P.H.M. (2009). Anemia and 9-year domain specific cognitive decline in community-dwelling older women: the women's health and aging study. Journal of the American Geriatrics Society, 57, 1604–1611.CrossRefGoogle ScholarPubMed
Dewey, M. E. and Copeland, J. R. (2001). Diagnosis of dementia from the history and aetiology schedule. International Journal of Geriatric Psychiatry, 16, 912–917.CrossRefGoogle ScholarPubMed
Ezekowitz, J. A., McAlister, F. A. and Armstrong, P. W. (2003). Anemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12 065 patients with new-onset heart failure. Circulation, 107, 223–225.CrossRefGoogle Scholar
Guralnik, J. M., Eisenstaedt, R. S., Ferrucci, L., Klein, H. G. and Woodman, R. C. (2004). Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood, 104, 2263–2268.CrossRefGoogle ScholarPubMed
Hall, K. S., Gao, S., Emsley, C. L., Ogunniyi, A. O., Morgan, O. and Hendrie, H. C. (2000). Community screening interview for dementia (CSI ‘D’); performance in five disparate study sites. International Journal of Geriatric Psychiatry, 15, 521–531.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Halm, E. A. et al. (2004). The effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture. Journal of Orthopaedic Trauma, 18, 369–374.CrossRefGoogle ScholarPubMed
Jardim-Botelho, A. et al. (2008). Age patterns in undernutrition and helminth infection in a rural area of Brazil: associations with ascariasis and hookworm. Tropical Medicine and International Health, 13, 458–467.CrossRefGoogle Scholar
McCall, D. T., Sauaia, A., Hamman, R. F., Reusch, J. E. and Barton, P. (2004). Are low-income elderly patients at risk for poor diabetes care? Diabetes Care, 27, 1060–1065.CrossRefGoogle ScholarPubMed
Milward, E. A., Grayson, D. A., Creasev, H., Janu, M. R., Brooks, W. S. and Broe, G. A. (1999). Evidence for association of anaemia with vascular dementia. Journal of Clinical Neuroscience, 10, 2377–2381.Google ScholarPubMed
Pandav, R. S., Chandra, V., Dodge, H. H., DeKosky, S. T. and Ganguli, M. (2004). Hemoglobin levels and Alzheimer disease: an epidemiologic study in India. American Journal of Geriatric Psychiatry, 12, 523–526.CrossRefGoogle ScholarPubMed
Prince, M. (2000). Methodological issues for population-based research into dementia in developing countries: a position paper from the 10/66 Dementia Research Group. International Journal of Geriatric Psychiatry, 15, 21–30.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Prince, M. et al. (2005). Effects of education and culture on the validity of the Geriatric Mental State and its AGECAT algorithm. British Journal of Psychiatry, 185, 429–436.CrossRefGoogle Scholar
Roberts, T. L., Foley, R. N., Weinhandl, E. D., Gilbertson, D. T. and Collins, A. J. (2006). Anaemia and mortality in haemodialysis patients: interaction of propensity score for predicted anaemia and actual haemoglobin levels. Nephrology Dialysis Transplantation, 21, 1652–1662.CrossRefGoogle ScholarPubMed
Sanderson, M., Wang, J., Davis, D. R., Lane, M. J., Cornman, C. B. and Fadden, M. K. (2002). Co-morbidity associated with dementia. American Journal of Alzheimer's Disease and Other Dementias, 17, 73–78.CrossRefGoogle ScholarPubMed
Scazufca, M. et al. (2008a). Risk factors across the life course and dementia in a Brazilian population: results from the Sao Paulo Ageing & Health Study. International Journal of Epidemiology, 37, 879–890CrossRefGoogle Scholar
Scazufca, M. et al. (2008b). High prevalence of dementia among older adults from poor socioeconomic backgrounds in São Paulo, Brazil. International Psychogeriatrics, 20, 394–405CrossRefGoogle ScholarPubMed
Valenzuela, M. J. (2008). Brain reserve and the prevention of dementia. Current Opinion in Psychiatry, 21, 296–302.CrossRefGoogle ScholarPubMed
Welsh, K. A. et al. (1994). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology, 44, 609–614.CrossRefGoogle Scholar
World Health Organization (2001). Iron Deficiency Anaemia: Assessment, Prevention, and Control: A Guide for Programme Managers. Available at http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/en/ida_assessment_prevention_control.pdf; last accessed 11 March 2011.Google Scholar