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Older people with anemia and muscle weakness have a higher risk of dying (38 notícias)

Publicado em 29 de agosto de 2022

A study conducted by researchers from the Federal University of São Carlos (UFSCar) and University College London (United Kingdom) indicates that the combination of anemia and muscle weakness in the elderly increases the risk of dying within by ten years by 64% in the case of men and by 117% in women.

Anemia alone increases the risk of dying by 58% in the case of older men. For women, muscle weakness is, in isolation, a more important risk factor, increasing the risk of death by 68%. And, according to a study published in the Archives of Gerontology and Geriatrics, the two conditions together cause greater problems, especially for women.

“For women, the two conditions combined double the risk of death. This is a huge increase and therefore these factors need to be monitored in the clinic. When the patient goes to the office, it is up to the doctor to quickly identify the cause of anemia and treat it, in addition to discovering the cause of weakness and showing resistance exercise”, says Mariane Marques Luiz, doctoral student of the Postgraduate Program in Physiotherapy at UFSCar and author of the student

The group analyzed a database of 5,310 British older people who were followed for ten years as part of the English Longitudinal Study of Aging (Elsa) project. The work was supported by FAPESP.

Marques Luiz emphasizes that the general mortality data is taken into account and that the risk is higher for patients with the same condition regardless of factors such as: age, cigarette consumption, marital status , level of physical activity, memory performance, difficulty with instrumental activity and presence of heart , lung disease or cancer.

“We looked at all the causes of death and the results showed that the combination of these two conditions increases the risk of total mortality. This means that regardless of these problems, when you get older, you will have anemia and dynapenia [fraqueza muscular] becomes an important risk factor”, says Marques Luiz.

Among the 5,310 subjects evaluated in the study, 84% did not have anemia or muscle weakness. Only 10.7% had dynapenia, 3.8% had anemia and 1.5% lived with both conditions.

During the 10-year follow-up of the participants, 984 deaths occurred among these individuals, of which 63.7% were asymptomatic, 22.8% were dynapenic, 7.5% anemic, and 6% included dynapenia. and anemia.

lack of oxygen

Previous studies have shown that anemia is a predisposing factor in the loss of muscle strength. This is because for a person who is anemic it is more difficult for oxygen – which is obtained from red blood cells, a type of blood cell that is reduced when there is a lack of iron – to reach the muscle tissue. As a result of this deficient process, muscle oxygenation is impaired. This condition, known as hypoxia, affects every organ and tissue in the anemic organism.

“By itself, hypoxia can produce a series of changes in the body, such as peripheral arterial vasodilation and reduced capillary formation. It can also trigger heart dysfunction and inappropriately activate a system of protein. [renina-angiotensina-aldosterona] which controls, among other things, blood pressure”, explains Tiago da Silva Alexandre, professor in the Department of Gerontology at UFSCar and research advisor.

The researcher points out that all the consequences of hypoxia can be reflected in the increased risk of both cardiovascular disease and mortality in general.

“When an elderly person has anemia, he is more likely to have dynapenia. And when he combines the two conditions we have a more complicated problem. This is because, in addition to the lack of hemoglobin and iron, there is an effect of low production of red blood cells in the musculoskeletal system”, he explained.

Differences between the sexes

In addition to investigating the combined effect of anemia and dynapenia in the elderly, the researchers also looked at whether the effect differed between men and women. According to the results of the study, in addition to having a higher incidence of both problems in women, the combination of these two conditions is more dangerous for them.

“First, there is a math issue. In women, the prevalence of anemia is slightly higher. It is worth noting that the cut-off points are also different to define anemia in men and women”, said Alexandre.

However, women appear to be more susceptible to the effects of anemia on the musculoskeletal system. “This difference may be due to the fact that men generally have more muscles and, when they have anemia, the musculoskeletal system is less affected. But this is only one of the possible explanations”, he said .

Alexandre pointed out that dynapenia alone is a risk factor for mortality for women, whereas anemia is not. “Since women usually have a significant loss of muscle mass in old age, the loss of muscle mass can already occur, which is accentuated by anemia”, he explained.

Men, although generally having more lean mass, lose muscle faster than women during the aging process. “But women in general have a lower amount of muscle mass and this can lead to a reduction in strength over time, which affects mortality. Dynapenia is an indicator that something bad is going on with health of the elders”, he warned.

(A.Fapesp)

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