Journal de la nutrition et des sciences alimentaires
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Improved Prevalence of Anemia and Nutritional Status among Japanese Elderly Participants in the National Health and Nutritional Survey Japan, 2003-2009

Imai E, Nakade M, Kasaoka Tsuboyama and Takimoto H

Objectives: This study aimed 1) to examine the trends in the prevalence of anemia of the Japanese elderly population and 2) to evaluate the association between hemoglobin concentrations and diet and lifestyle factors, by using data from a population-based, nationwide cross-sectional survey in Japan, from 2003-2009.
Design: A cross-sectional nationally representative survey.
Setting: Japan.
Participants: A nationally representative sample of 10,606 community dwelling men (n=4656) and women (n=5950) aged 65 years and over.
Measurements: Information on anthropometry, dietary intake status, information on current medication, lifestyle habits, and blood biomarker measurements were obtained from the participants. Anemia was defined as hemoglobin concentrations <130 g/L in men and <120 g/L in women. Logistic regression analysis adjusted for subject age was applied to estimate the effect of survey year to anemia prevalence. Multiple regression analysis was applied to estimate the effect of survey year and clinical, dietary and lifestyle factors to hemoglobin values.
Results: Anemia prevalence was 19.3% in men and 21.7% in women. When adjusted for age, the prevalence of anemia significantly decreased by each survey year in both men (odds ratio: 0.933, 95% confidence interval: 0.899, 0.968, p<0.001) and women (odds ratio: 0.968, 95% confidence interval: 0.939, 0.999, p=0.040). The multivariate model explained 25% and 22% of the variance in hemoglobin values in men and women, respectively. In both men and women, each unit of increase in BMI, daily smoking, serum ferritin and albumin was positively associated to hemoglobin values, and age was negatively associated. After adjusting for all factors, hemoglobin values were estimated to increase 0.66 g/L per year in men, and 0.68 g/L per year in women.
Conclusion: Nutritional status of the Japanese elderly as observed by anemia prevalence and hemoglobin concentrations has improved in recent years.