Relationship Between Anemia, Hemoglobin Level and Risk of Osteosarcopenia in Community-Dwelling Older Adults: The Bushehr Elderly Health (Beh) Program Publisher Pubmed



Gholizade M^{1, 6} ; Marzban M^{2, 3} ; Jamshidi A^{4, 5} ; Afshar A^{5, 6} ; Afshar M^{5, 6} ; Kalantarhormozi M⁵ ; Nabipour I⁵ ; Larijani B⁷ ; Farhadi A⁵ Show Affiliations
Source: Archives of Osteoporosis Published:2025

Abstract

Summary: This study investigates the relationship between anemia, hemoglobin levels, and osteosarcopenia risk in older adults. Analyzing data from 2,398 participants in the Bushehr Elderly Health program, the research reveals that anemia significantly increases osteosarcopenia risk. The findings suggest that routine hemoglobin screening and anemia treatment could help prevent osteosarcopenia in the elderly population. Purpose: In the older adult population, osteosarcopenia, defined as having both sarcopenia and osteopenia, is a recent concern. In this study, we aimed to evaluate anemia as a common condition in the older adult population and osteosarcopenia. Given that anemia can contribute to musculoskeletal decline through impaired oxygen delivery and metabolic dysfunction, we hypothesized that lower hemoglobin levels and anemia may be significant risk factors for osteosarcopenia. This study aims to investigate this potential relationship in an elderly population. Methods: This cross-sectional study was conducted on men and women ≥ 60 years, based on the second phase of the Bushehr elderly health (BEH) program. Osteopenia/osteoporosis was defined as a t-score ≤—1.0 standard deviation below the mean values of a young healthy adult and sarcopenia was defined based on the revised edition of the European Working Group on Sarcopenia in Older People (EWGSOP2) based on the Iranian cut-off point. Anemia is defined as 12 for women and 13 g/dl for men. We calculated odds ratios (OR), 95% confidence intervals (95% CI), and adjusted OR (AOR) using univariate and adjusted multivariate logistic regression. Results: Among 2398 who enrolled, 534 (22.27%) of participants had osteosarcopenia. The mean level of hemoglobin (Hgb) was 14.49 ± 1.73, and 219 participants (9.13%) were diagnosed with anemia. Participants with osteosarcopenia were more likely to be older, have lower body mass index, suffer from frailty syndrome and cognitive disorder, and have anemia. Moreover, analysis showed lower levels of Hgb were associated with osteosarcopenia (AOR = 0.89, 95% CI: 0.82–0.96) and anemia almost increase 1.5 times risk of osteosarcopenia (AOR = 1.55, 95% CI: 1.05–2.30). Conclusion: The results of this study indicate that anemia dramatically increased the risk of osteosarcopenia. Routine Hgb screening and treatment of anemia might prevent the older adult population from osteosarcopenia. © International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation 2025.