Late-life anemia is associated with increased risk of recurrent falls

OBJECTIVES: To examine whether anemia is associated with a higher incidence of recurrent falls. DESIGN: Prospective cohort study. SETTING: Community-dwelling sample in The Netherlands. PARTICIPANTS: Three hundred ninety-four participants aged 65 to 88 from the Longitudinal Aging Study Amsterdam. MEASUREMENTS: Anemia was defined according to World Health Organization criteria as a hemoglobin concentration less than 12 g/dL in women and less than 13 g/dL in men. Falls were prospectively determined using fall calendars that participants filled out weekly for 3 years. Recurrent fallers were identified as those who fell at least two times within 6 months during the 3-year follow-up. RESULTS: Of the 394 persons, 11.9% (18 women and 29 men) had anemia. The incidence of recurrent falls was 38.3% of anemic persons versus 19.6% of nonanemic persons (P=.004). After adjustment for sex, age, body mass index, and diseases, anemia was significantly associated with a 1.91 times greater risk for recurrent falls (95% confidence interval=1.09-3.36). Poor physical function (indicated by muscle strength, physical performance, and limitations) partly mediated the association between anemia and incidence of recurrent falls. CONCLUSION: Late-life anemia is common and associated with twice the risk of recurrent falls. Muscle weakness and poor physical performance appear to partly mediate this association.