Seminars in Hematology
Volume 45, Issue 4 , Pages 210-217 , October 2008

Epidemiology of Anemia in Older Adults

  • Kushang V. Patel

      Affiliations

    • Corresponding Author InformationAddress correspondence to Kushang V. Patel, PhD, MPH, 7201 Wisconsin Ave, Gateway Building, Suite 3C309, Bethesda, MD 20892-9205

References 

  1. United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects (The 2006 Revision). New York, NY: United Nations; 2007;
  2. Federal Interagency Forum on Aging-Related Statistics. Older Americans Update 2008: Key Indicators of Well-Being. Washington, DC: US Government Printing Office; 2008;
  3. Chaves PH, Xue QL, Guralnik JM, Ferrucci L, Volpato S, Fried LP. What constitutes normal hemoglobin concentration in community-dwelling disabled older women?. J Am Geriatr Soc. 2004;52:1811–1816
  4. Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR. Impact of anemia on hospitalization and mortality in older adults. Blood. 2006;107:3841–3846
  5. Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med. 2006;119:327–334
  6. Izaks GJ, Westendorp RG, Knook DL. The definition of anemia in older persons. JAMA. 1999;281:1714–1717
  7. Patel KV, Harris TB, Faulhaber M, Angleman SB, Connelly J, Bauer DC, et al. Racial variation in the relationship of anemia with mortality and mobility disability among older adults. Blood. 2007;109:4663–4670
  8. Penninx BW, Pahor M, Woodman RC, Guralnik JM. Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci. 2006;61:474–479
  9. Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, et al. A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med. 2005;165:2214–2220
  10. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004;104:2263–2268
  11. Inelmen EM, D'Alessio M, Gatto MR, BAggio MB, Jimenez G, Bizzotto MG, et al. Descriptive analysis of the prevalence of anemia in a randomly selected sample of elderly people living at home: some results of an Italian multicentric study. Aging (Milano). 1994;6:81–89
  12. Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc. 2004;52:719–724
  13. Salive ME, Cornoni-Huntley J, Guralnik JM, Phillips CL, Wallace RB, Ostfeld AM, et al. Anemia and hemoglobin levels in older persons: Relationship with age, gender, and health status. J Am Geriatr Soc. 1992;40:489–496
  14. Ania BJ, Suman VJ, Fairbanks VF, Melton LJ. Prevalence of anemia in medical practice: community versus referral patients. Mayo Clin Proc. 1994;69:730–735
  15. Skjelbakken T, Langbakk B, Dahl IM, Lochen ML. Haemoglobin and anaemia in a gender perspective: The Tromsø Study. Eur J Haematol. 2005;74:381–388
  16. Perry GS, Byers T, Yip R, Margen S. Iron nutrition does not account for the hemoglobin differences between blacks and whites. J Nutr. 1992;122:1417–1424
  17. Johnson-Spear MA, Yip R. Hemoglobin difference between black and white women with comparable iron status: Justification for race-specific anemia criteria. Am J Clin Nutr. 1994;60:117–121
  18. Beutler E, Waalen J. The definition of anemia: What is the lower limit of normal of the blood hemoglobin concentration?. Blood. 2006;107:1747–1750
  19. Robins EB, Blum S. Hematologic reference values for African American children and adolescents. Am J Hematol. 2007;82:611–614
  20. Beutler E, West C. Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on hemoglobin levels and mean corpuscular volume. Blood. 2005;106:740–745
  21. International Nutritional Anemia Consultative Group. Adjusting Hemoglobin Values in Program Surveys. Washington, DC: ILSI Human Nutrition Institute; 2002;
  22. In:  Earl R,  Woteki CE editor. Iron Deficiency Anemia: Recommended Guidelines for the Prevention, Detection, and Management Among US children and Women of Childbearing Age. Food and Nutrition Board, Institute of Medicine. Washington, DC: National Academy Press; 1993;
  23. WHO/UNICEF/UNU. Iron Deficiency Anemia, Assessment, Prevention and Control: A Guide for Programme Managers. WHO/NHD/01.3. Geneva, Switzerland: WHO; 2001;
  24. Artz AS, Fergusson D, Drinka PJ, Gerald M, Gravenstein S, Lechich A, et al. Prevalence of anemia in skilled-nursing home residents. Arch Gerontol Geriatr. 2004;39:201–206
  25. Robinson B, Artz AS, Culleton B, Critchlow C, Sciarra A, Audhya P. Prevalence of anemia in the nursing home: Contribution of chronic kidney disease. J Am Geriatr Soc. 2007;55:1566–1570
  26. Landi F, Russo A, Danese P, Liperoti R, Barillaro C, Bernabei R, et al. Anemia status, hemoglobin concentration, and mortality in nursing home older residents. J Am Med Dir Assoc. 2007;8:322–327
  27. Ania BJ, Suman VJ, Fairbanks VF, Rademacher DM, Melton LJ. Incidence of anemia in older people: An epidemiologic study in a well defined population. J Am Geriatr Soc. 1997;45:825–831
  28. Ferrucci L, Maggio M, Bandinelli S, Basaria S, Lauretani F, Ble A, et al. Low testosterone levels and the risk of anemia in older men and women. Arch Intern Med. 2006;166:1380–1388
  29. Choi CW, Lee J, Park KH, Choi IK, Kim SJ, Seo JH, et al. Incidence of anemia in older Koreans: Community-based cohort study. Arch Gerontol Geriatr. 2005;41:303–309
  30. Tang WH, Tong W, Jain A, Francis GS, Harris CM, Young JB. Evaluation and long-term prognosis of new-onset, transient, and persistent anemia in ambulatory patients with chronic heart failure. J Am Coll Cardiol. 2008;51:569–576
  31. Drewnowski A, Shultz JM. Impact of aging on eating behaviors, food choices, nutrition, and health status. J Ntrn Health Aging. 2001;5:75–79
  32. Coban E, Timuragaoglu A, Meric M. Iron deficiency anemia in the elderly: Prevalence and endoscopic evaluation of the gastrointestinal tract in outpatients. Acta Haematol. 2003;110:25–28
  33. Rockey DC, Cello JP. Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med. 1993;329:1691–1695
  34. Joosten E, Ghesquiere B, Linthoudt H, Krekelberghs F, Dejaeger E, Boonen S, et al. Upper and lower gastrointestinal evaluation of elderly inpatients who are iron deficient. Am J Med. 1999;107:24–29
  35. Casale G, Bonora C, Migliavacca A, Zurita IE, de Nicola P. Serum ferritin and ageing. Age Ageing. 1981;10:119–122
  36. Witte DL. Can serum ferritin be effectively interpreted in the presence of the acute-phase response?. Clin Chem. 1991;37:484–485
  37. Rimon E, Levy S, Sapir A, Gelzer G, Peled R, Ergas D, et al. Diagnosis of iron deficiency anemia in the elderly by transferrin receptor-ferritin index. Arch Intern Med. 2002;162:445–449
  38. Ferrucci L, Guralnik JM, Bandinelli S, Semba RD, Lauretani F, Corsi A, et al. Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro-inflammatory markers. Br J Haematol. 2007;136:849–855
  39. Balducci L. Epidemiology of anemia in the elderly: Information on diagnostic evaluation. J Am Geriatr Soc. 2003;51(suppl 3):S2–S9
  40. Carmel R, Green R, Rosenblatt DS, Watkins D. Update on cobalamin, folate, and homocysteine. Hematology Am Soc Hematol Educ Program. 2003;62–81
  41. Savage DG, Lindenbaum J, Stabler SP, Allen RH. Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. Am J Med. 1994;96:239–246
  42. Stabler SP, Lindenbaum J, Allen RH. The use of homocysteine and other metabolites in the specific diagnosis of vitamin B-12 deficiency. J Nutr. 1996;126(suppl 4):1266S–1272S
  43. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005;352:1011–1023
  44. Keller CR, Odden MC, Fried LF, Newman AB, Angleman S, Green CA, et al. Kidney function and markers of inflammation in elderly persons without chronic kidney disease: The Health, Aging, and Body Composition Study. Kidney Int. 2007;71:239–244
  45. Astor BC, Muntner P, Levin A, Eustace JA, Coresh J. Association of kidney function with anemia: The Third National Health and Nutrition Examination Survey (1988-1994). Arch Intern Med. 2002;162:1401–1408
  46. Ble A, Fink JC, Woodman RC, Klausner MA, Windham BG, Guralnik JM, et al. Renal function, erythropoietin, and anemia of older persons: the InCHIANTI study. Arch Intern Med. 2005;165:2222–2227
  47. Cumming RG, Mitchell P, Craig JC, Knight JF. Renal impairment and anaemia in a population-based study of older people. Intern Med J. 2004;34:20–23
  48. Hsu CY, McCulloch CE, Curhan GC. Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: Results from the Third National Health and Nutrition Examination Survey. J Am Soc Nephrol. 2002;13:504–510
  49. Artz AS, Fergusson D, Drinka PJ, Gerald M, Bidenbender R, Lechich A, et al. Mechanisms of unexplained anemia in the nursing home. J Am Geriatr Soc. 2004;52:423–427
  50. Strom SS, Velez-Bravo V, Estey EH. Epidemiology of myelodysplastic syndromes. Semin Hematol. 2008;45:8–13

 Supported by the Intramural Research Program of the US National Institute on Aging, National Institutes of Health.

PII: S0037-1963(08)00115-7

doi: 10.1053/j.seminhematol.2008.06.006

Seminars in Hematology
Volume 45, Issue 4 , Pages 210-217 , October 2008

Article Tools

* Image Usage & Resolution