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Red cell distribution width and mortality in older adults: a meta-analysis
Kushang V Patel1, Richard D Semba, Luigi Ferrucci
1Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland 20892-9205, USA. kushang.patel@nih.gov
Summary
Red cell distribution width (RDW), a measure of red blood cell size variation, predicts mortality in older adults. Higher RDW levels are linked to increased death risk from all causes, including cardiovascular disease and cancer.
Area of Science:
- Gerontology
- Hematology
- Epidemiology
Background:
- Red cell distribution width (RDW) quantifies erythrocyte size variability, indicating cell heterogeneity.
- Elevated RDW is linked to increased mortality in cardiovascular disease (CVD) patients.
- Prognostic value of RDW in general community populations remains unclear.
Purpose of the Study:
- To investigate the prognostic significance of RDW in community-dwelling older adults.
- To determine if RDW predicts mortality across diverse demographic and health subgroups.
Main Methods:
- Meta-analysis of individual participant data from seven community-based studies.
- Included 11,827 older adults with RDW measurements and mortality data.
- Cox proportional hazards regression models were used for analysis.
Main Results:
- Higher RDW values showed a graded association with increased all-cause mortality (p < .001).
- Each 1% RDW increase correlated with a 14% rise in total mortality risk (aHR: 1.14).
- RDW predicted mortality from CVD, cancer, and other causes, and remained significant in subgroups and those without major diseases.
Conclusions:
- RDW is a potent, routinely available predictor of mortality in community-dwelling older adults.
- The association between RDW and mortality is robust across various subgroups.
- Further research into the biological mechanisms underlying RDW's prognostic role is warranted.
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