@article {Payne796,
	title = {Cross-sectional relationship between haemoglobin concentration and measures of physical and cognitive function in an older rural South African population},
	journal = {Journal of Epidemiology \& Community Health},
	volume = {72},
	number = {9},
	year = {2018},
	pages = {796{\textendash}802},
	publisher = {BMJ Publishing Group Ltd},
	abstract = {Background Age cohort differences in haemoglobin concentrations and associations with physical and cognitive performance among populations of lower income and middle-income countries have not previously been described. We examined the association between these factors among older men and women in rural South Africa.Methods We analysed cross-sectional data from a population-based study of rural South African men and women aged 40 and over (n=4499), with data drawn from questionnaire responses, a cognitive battery, objective physical function tests and blood tests. Anaemia was defined as a haemoglobin concentration \&lt;12 g/dL for women and \&lt;13 g/dL for men. We related haemoglobin concentrations to each of age, grip strength, walk speed and a latent cognitive function z-score for men and women separately. We used unadjusted correlations and linear models to adjust for comorbidities and inflammation.Results In total, 1042 (43.0\%) women and 833 (40.1\%) men were anaemic. Haemoglobin concentrations were inversely correlated with age for men but not for women; in adjusted analyses, haemoglobin was 0.3 g/dL lower per decade older for men (95\% CI 0.2 to 0.4 g/dL). In adjusted analyses, haemoglobin concentration was independently associated with grip strength in women (B=0.391, 95\% CI 0.177 to 0.605), but this did not reach significance in men (B=0.266, 95\% CI -0.019 to 0.552); no associations were observed between haemoglobin levels and walk speed or cognitive score.Conclusions Anaemia was prevalent in this study population of middle-aged and older, rural South African adults, but in contrast to high-income countries, it was not associated with poor physical or cognitive function. Our findings need to be replicated in other populations.},
	issn = {0143-005X},
	doi = {10.1136/jech-2018-210449},
	url = {https://jech.bmj.com/content/72/9/796},
	author = {Payne, Collin F and Davies, Justine I and Gomez-Olive, F Xavier and Hands, Katherine J and Kahn, Kathleen and Kobayashi, Lindsay C and Tipping, Brent and Tollman, Stephen M and Wade, Alisha and Witham, Miles D}
}
