Research Article: Hematological parameters and all-cause mortality: a prospective study of older people

Date Published: June 29, 2017

Publisher: Springer International Publishing

Author(s): Joanna Frąckiewicz, Dariusz Włodarek, Anna Brzozowska, Elżbieta Wierzbicka, Małgorzata Anna Słowińska, Lidia Wądołowska, Joanna Kałuża.


The effect of low and high concentration of some hematological parameters in the blood can have a negative impact on health.

Therefore, we investigated the associations between hematological parameters and all-cause mortality among older people living in Poland.

The study was carried out among 75–80-year-old participants (n = 403) from Warsaw and Olsztyn regions, Poland. Information on lifestyle factors and food consumption were obtained at baseline (June 1, 1999) using a self-administered questionnaire. Red blood cell, haemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and mean corpuscular haemoglobin concentration (MCHC) were determined. The data on deaths from all-causes were collected from the baseline until October 31, 2006. During an average of 7.4 years of follow-up, we ascertained 154 cases of death from all-causes.

Compared with men in the lowest tertile of MCV, MCH, and MCHC, the multivariable hazard ratios (HRs) of all-cause mortality in those in the highest tertile were 0.35 (95% CI, 0.17–0.73), 0.32 (95% CI, 0.16–0.67), and 0.44 (95% CI, 0.22–0.88), respectively. In contrast, among women after combining the second and the third tertiles of MCV, MCH, and MCHC, the HRs were 2.01 (95% CI, 1.01–3.99), 1.71 (95% CI, 0.85–3.43), and 1.09 (95% CI, 0.62–1.94), respectively.

We observed inverse associations between some hematological parameters and all-cause mortality among men, but not among women. This may be explained by a difference in iron metabolism, iron status, hormone regulations, or the occurrence of some diseases.

Partial Text

The prevalence of anaemia increases dramatically with advancing age, reaching nearly 50% in older people, and will be increased further due to population aging [1–3]. Most anaemia cases in older individuals result from iron deficiency, chronic inflammation, chronic kidney disease, or some of them may be unexplained [4–6]. Anaemia of inflammation is one of the main types of anaemia in the geriatric population and is connected to many age-related diseases such as: obesity, cancer, chronic renal disease, etc. Even mild anaemia is related to increased mortality [7, 8]. Low haemoglobin (Hb) concentration contributes to pathological conditions, such as poor functional status, cognitive decline and dementia, increased risk of hospitalization, morbidity, and mortality [9–12].

The mean age of participants was 77.0 ± 1.7 years (Table 1). Over half of the respondents were women (52.9%) and lived in the Warsaw region (53.3%). Most participants evaluated their physical activity as moderate or high and had primary or secondary education. Twenty percent of men and about six percent of women were current smokers, and 14 and 22%, respectively, declared to avoid alcohol. In the past 12 months, dietary supplements and medicine were used by 41 and 72% of participants, respectively. About 73% of respondents had a BMI higher than 25 kg/m2. The concentration of serum cholesterol was statistically significantly higher in women compared to men, while the intake of energy and iron was significantly lower in women.

In this study of older people, some hematological parameters were inversely associated with a risk of all-cause mortality among men, but not among women. Men in the highest versus those in the lowest tertile of MCV, MCH, and MCHC had a statistically significant 65, 68, and 56% lower risk of all-cause mortality, respectively. In contrast, women in the higher tertiles of MCV (the second and the third tertiles combined) in comparison to those in the first tertile had a twofold higher risk of all-cause mortality. No similar associations were observed for RBC, Hb, and HCT. Moreover, in our previous study in the same population of men and women, we observed that women with iron serum concentration above the median had a statistically significantly fourfold (HR: 4.10; 95% CI: 1.16–14.5) higher risk of all-cause mortality than those with lower iron serum concentration. In men, a similar association was not observed [19].

The findings from this prospective study indicate that some hematological parameters were inversely associated with the risk of all-cause mortality among older men, but not among women. The differences in the results between genders can be explained by different iron metabolism, iron status, and hormone regulations among men and women, and also by the occurrence of diseases, which can have an impact on hematological parameters. This finding warrants confirmation in further prospective studies conducted on a bigger population.




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