Learning Objective #1: Describe the effects of anemia on physical function, activities of daily living and falls

Learning Objective #2: Described the combined effects of anemia and physical function on falls

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Although anemia has been associated with poorer physical performance and falls among community dwelling elders, its effects have not been studied among hospitalized elderly adults. 373 women and 378 men were recruited before transfer from intensive care units (medical, surgical, cardiac and neurosurgery).  They ranged in age from 40 to 96 years (mean=63.9, SD=12.2).  69.1% had anemia using the World Health Organization classification (hemoglobin [Hgb] < 12.0 for women, < 13 for men). Significantly more women had anemia (74.3%) than men (66.4%; X²=5.6, p<.05), but age was not significantly different between those with and without anemia. Those with anemia had significantly poorer physical function:  balance, gait (Tinetti Mobility Assessment), muscle strength of the leg (dynamometer and normalized by body weight) and greater dependency in ADLs (Katz Index of ADL). In spite of significantly lower physical function and greater dependence in ADL, anemic subjects were not more likely to fall after transfer from ICU (13.6%) than those without anemia (9.9%).  Using logistic regression to predict fall status, anemia was not a significant predictor of falls, but poorer gait and dependency in ADLs were significant (OR=0.92 and 1.1, respectively). Poor physical function and greater dependency are more important risk factors for falls than anemia although anemia is significantly associated with poorer physical function and greater dependency in ADLs.  Anemia has been found to be associated with poorer physical function and dependency, and interventions should target anemia, physical function and chronic conditions that contribute to anemia.