The objectives of this study were to determine if a relationship exists between a history of falls and
anemia in older adults and to compare the findings by place of residence.
DESIGN: The authors conducted a retrospective and observational study.
PARTICIPANTS: One hundred forty-five adults (60-97 years of age) from nursing homes and the community hospitalized for hip fracture over a 2-year period were included in this study.
MEASUREMENTS: Falls occurred similarly in both
nursing home patients and community patients (19% vs. 17%, P=0.785).
Nursing home and community patients also had similar
Hb (P=0.0899), Hct (P=0.1929), and rates of
anemia (P=0.187).
Nursing home residents were older (P=0.0188) and had lower
serum albumin levels (P=0.0007) than community patients. When the two groups were combined, falls were more common in anemic individuals (30% vs. 13%; P=0.028). Furthermore, those with a history of falls were older (P=0.0447), had lower
Hb (P=0.0257) and Hct levels (P=0.0310). After controlling for age, gender, place of residence, and
arthritis in a logistic regression model,
anemia predicted a threefold increased risk of falls (P=0.041), and a 45% decreased risk of falls was predicted for every 1.0-g/dL increase in
Hb (P=0.005). Falls risk increased 7% per year of age (P=0.040), whereas
musculoskeletal disease increased the falls risk 3.2-fold, both increases being independent of Hb levels or
anemia. Finally, falls were not associated with gender or other comorbidity, nor did these variables alter the falls risk attributed to low Hb or
anemia.
CONCLUSIONS: These findings suggest a new and potentially important link between
anemia and the risk of falls in patients sustaining
hip fractures from both nursing homes and the community. Further studies will help determine if this risk is modified or eliminated with treatment of
anemia and if the relationship applies to larger samples of older adults in different settings.