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Background: Anemia commonly occurs in the elderly (≥65), and has been associated with a number of adverse consequences. Thirty percent of the community-dwelling elderly fall annually and this risk increases to 50% by the age of 80. Serious injuries caused by a fall, such as fractures and head injuries, are sustained by about 10% of the elderly and often lead to functional disability, increased health care costs, and increased mortality. Identification of reversible risk factors is critical for the management of falls and related injuries. The purpose of the current study is to investigate whether anemia increases the risk of injurious falls (IF) in the elderly. Methods: Health claims data from over 30 health plans from 01/1999 through 04/2004 were used. Patients ≥65 years with ≥1 hemoglobin (Hb) measurement were selected. IF were defined as a fall claim followed by an injurious event claim within 30 days after the fall. Injurious events were defined as fractures of the hip, pelvis, femur, vertebrae, ribs, humerus, and lower limbs, Colle’s fracture, head injuries, or hematomas. An open-cohort design was employed to classify patients’ observation periods by: (1) by anemia status based on WHO criteria (< 12 g/dL for women; < 13 g/dL for men), and (2) by Hb level: Results: Among the 47,530 study subjects, a statistically significant linear trend of increasing risk of falls (i.e., IF and non-IF events) with decreasing Hb was observed (p Conclusion: Anemia was significantly and independently associated with an increasing risk for IF, especially IF to the hip and head, in elderly persons. Furthermore, the risk of IF increased as the anemia worsened. The impact of anemia correction on the risk of falls and IF needs to be evaluated.

Background: Anemia is common in the elderly (≥65) and increases with age, reaching 26% in community dwelling (CD) men 85 yrs and older. Falls, especially those leading to serious injuries such as a fracture or head injury, affect about 10% of the CD elderly. The prevalence of anemia and the occurrence of falls is even higher in nursing home residents. Falls in the elderly are a significant cause of functional disability and significantly increase health care burden. This analysis was performed to determine if the presence of anemia significantly increases medical costs related to injurious falls (IF) in the CD elderly. Methods: A retrospective economic analysis of medical claims from over 30 health plans from 01/1999 through 04/2004 was conducted. Patients ≥65 years with ≥1 hemoglobin (Hb) reading were selected. An open-cohort design was employed to classify patients’ observation period into anemic and non-anemic periods. Anemia was defined as Hb