Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor
In Reply: Dr Hassaballa correctly notes that
the increased mortality risk associated with anemia in older persons disappeared
after 5 to 10 years of follow-up in our study. Several mechanisms may explain
why the mortality risk decreases after long periods of follow-up. First, chronic
but nonfatal diseases may have caused the anemia in persons who were still
alive 5 years after blood sampling. Second, the hemoglobin concentration measured
at baseline may have been incidentally low due to nonfatal intercurrent disease.
Third, the underlying disease causing anemia could have been successfully
treated. Fourth, the number of persons with anemia who were alive 5 years
after blood sampling was small (n = 18). Therefore, the study may simply lack
power to detect different mortality in persons with and without anemia after
long periods of follow-up.
Izaks GJ, Westendorp RGJ. Woman. JAMA. 1999;282(21):2001. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-21-jbk1201