Estudo da anemia em longevos com independência funcional

• Autor(a) principal: Moraes, Niele Silva de [UNIFESP]
• Data de Publicação: 2016
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4194617; http://repositorio.unifesp.br/handle/11600/46712
• topic: Elderly; Hemoglobin; Anemia; Prevalence; Idosos; Hemoglobina; Anemia; Prevalência

Lower levels of hemoglobin have been often observed in the elderly population, but it has been discussed whether anemia is a physiological consequence of aging or a negative clinical feature. Objetives: The aims of this study were to evaluate hemoglobin levels in a Brazilian population of oldest old with active aging; describe the prevalence and causes of anemia in this population and its impact on survival. Patients and Methods: This was a prospective observational study of community-dwelling independent elderly aged 80 years or older in the city of São Paulo, Brazil. Patients were excluded if institutionalized, diagnosed with dementia, Parkinson disease or current cancer, were under dialysis or were hospitalized in the last 3 months. Reference range of Hb levels was calculated e according to recommendations of the International Federation of Clinical Chemistry (IFCC). Results: Of 256 subjects included in this study, 182 (71%) were women, median age was 85 years old (80?99). A total of 47 individuals met exclusion criteria for statistical analysis. The median hemoglobin level was 13.9 g/dL in men and 13.3 g/dL in women. Calculated 0.95 reference range of hemoglobin concentration was 11.2-16.7g/dL for men and 11.3-15.7 g/dL in women. According to WHO criteria, 40 patients (15,6%) had anemia. The major cause of anemia was chronic kidney disease (CKD), present as single cause of anemia in 40.0% of patients. Iron deficiency was the second most common cause of anemia (37.5% of cases). Patients with anemia had significantly lower glomerular filtration rate (42.7ml/min/1.73m2 vs. 50.6 ml/min/1.73m2, P=0.001). There was a significant association between anemia and osteoporosis (P=0.045) and osteoarthritis (P<0.001). No difference in survival of patients with or without anemia was observed (74% vs. 84%, P=0.22). Conclusion: A lower threshold of hemoglobin was found for both men and women when compared to levels set by WHO. Most of cases of anemia were secondary to CKD, followed by iron deficiency. Anemia was not associated with inferior survival in functionally independent oldest old men or women. Further studies must contribute to indicate the normal level of hemoglobin concentration in the elderly and clarify if anemia is actually a marker of other clinical conditions that may impact on survival of the elderly population. contribute to indicate the normal level of hemoglobin concentration in the elderly.