Journal of Cardiac Failure
Volume 12, Issue 7 , Pages 533-539, September 2006

Anemia, Physical Disability, and Survival in Older Patients With Heart Failure

  • Cinzia Maraldi, MD

      Affiliations

    • From the Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville, Florida
    • Section of Internal Medicine, Gerontology, and Geriatrics, Department of Clinical and Experimental Medicine, University of Ferrara, Italy
    • Corresponding Author InformationReprint requests: Cinzia Maraldi, MD, Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, 1329 SW 16th Street, Gainesville, FL 32608.
    • ,
  • Stefano Volpato, MD, MPH

      Affiliations

    • Section of Internal Medicine, Gerontology, and Geriatrics, Department of Clinical and Experimental Medicine, University of Ferrara, Italy
    • ,
  • Matteo Cesari, MD, PhD

      Affiliations

    • From the Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville, Florida
    • ,
  • Graziano Onder, MD, PhD

      Affiliations

    • Department of Geriatrics, Catholic University of Sacred Heart, Rome, Italy
    • ,
  • Claudio Pedone, MD, PhD

      Affiliations

    • Department of Geriatrics, Catholic University of Sacred Heart, Rome, Italy
    • ,
  • Richard C. Woodman, MD

      Affiliations

    • Ortho Biotech Clinical Affairs, LLC, Bridgewater, New Jersey
    • ,
  • Renato Fellin, MD

      Affiliations

    • Section of Internal Medicine, Gerontology, and Geriatrics, Department of Clinical and Experimental Medicine, University of Ferrara, Italy
    • ,
  • Marco Pahor, MD

      Affiliations

    • From the Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville, Florida
    • ,
  • Investigators of the Gruppo Italiano di Farmacoepidemiologia nell'Anziano Study

Received 5 December 2005; received in revised form 30 March 2006; accepted 5 May 2006.

Gainesville, Florida; Ferrara, Italy; Rome, Italy; Bridgewater, New Jersey

Abstract 

Background

Anemia is common in congestive heart failure, and it has been associated with poor prognosis. The effect of anemia on functional ability in heart failure has not been described. We evaluated the relationship of anemia, physical disability, and survival in patients with heart failure.

Methods and Results

One-year longitudinal study of 567 non-disabled, hospitalized heart failure patients, age ≥65 years, enrolled in the Italian Group of Pharmacoepidemiology in the Elderly Study. Anemia was defined according to the World Health Organization criteria. Physical disability was defined as dependence in performing at least 2 basic activities of daily living. After adjustment for disease severity and health-related variables, anemia was associated with higher risk of disability (odds ratio = 2.17; 95% confidence interval [CI] = 1.12–4.24). After stratification according to gender, a strong relationship of anemia and risk of disability persisted in women, but it was reduced in men. Anemic women were significantly more likely to die during the follow-up, even after adjustment for potential confounders (hazard ratio = 2.33; CI = 1.02–5.30).

Conclusion

Anemia is a predictor of physical disability in older heart failure patients, and in women anemia is associated with increased mortality.

Key Words: Anemia, Disability, Heart failure, Prognosis, Aging

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 This research was conducted on behalf of the investigators of the Gruppo Italiano di Farmacoepidemiologia nell'Anziano (GIFA). A complete list of the GIFA investigators has been published previously (Pharmacol Res 1999;40:287–95). Data analysis was supported by an educational grant from Ortho Biotech Clinical Affairs (Bridgewater, NJ).

PII: S1071-9164(06)00229-6

doi:10.1016/j.cardfail.2006.05.002

Journal of Cardiac Failure
Volume 12, Issue 7 , Pages 533-539, September 2006

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