Epidemiology of anemia in older adults.

Anemia is a common, multifactorial condition among older adults. The World Health Organization (WHO) definition of anemia (hemoglobin concentration <12 g/dL in women and <13 g/dL in men) is most often used in epidemiologic studies of older adults. More than 10% of community-dwelling adults age 65 years and older has WHO-defined anemia. After age 50 years, prevalence of anemia increases with advancing age and exceeds 20% in those 85 years and older. In nursing homes, anemia is present in 48% to 63% of residents. Incidence of anemia in older adults is not well characterized. Among older adults with anemia, approximately one third have evidence of iron, folate, and/or vitamin B(12) deficiency, another third have renal insufficiency and/or chronic inflammation, and the remaining third have anemia that is unexplained. Several studies demonstrate that anemia is associated with poorer survival in older adults. This review details the distribution and consequences of anemia in older adults and identifies future epidemiologic research needs.

[1]  G. Casale,et al.  Serum ferritin and ageing. , 1981, Age and ageing.

[2]  A. Parant.  [World population prospects]. , 1990, Futuribles.

[3]  D. Witte.  Can serum ferritin be effectively interpreted in the presence of the acute-phase response? , 1991, Clinical chemistry.

[4]  T. Byers,et al.  Iron nutrition does not account for the hemoglobin differences between blacks and whites. , 1992, The Journal of nutrition.

[5]  H. Cohen,et al.  Anemia and Hemoglobin Levels in Older Persons: Relationship with Age, Gender, and Health Status , 1992, Journal of the American Geriatrics Society.

[6]  D. Rockey,et al.  Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. , 1993, The New England journal of medicine.

[7]  L. Melton,et al.  Prevalence of anemia in medical practice: community versus referral patients. , 1994, Mayo Clinic proceedings.

[8]  G. Enzi,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 , 1994, Aging.

[9]  R. Yip,et al.  Hemoglobin difference between black and white women with comparable iron status: justification for race-specific anemia criteria. , 1994, The American journal of clinical nutrition.

[10]  R. Allen,et al.  Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. , 1994, The American journal of medicine.

[11]  R. Allen,et al.  The use of homocysteine and other metabolites in the specific diagnosis of vitamin B-12 deficiency. , 1996, The Journal of nutrition.

[12]  V. Suman,et al.  Incidence of Anemia in Older People: An Epidemiologic Study in a Well Defined Population , 1997, Journal of the American Geriatrics Society.

[13]  S. Boonen,et al.  Upper and lower gastrointestinal evaluation of elderly inpatients who are iron deficient. , 1999, The American journal of medicine.

[14]  D. Knook,et al.  The definition of anemia in older persons. , 1999, JAMA.

[15]  A. Drewnowski,et al.  Impact of aging on eating behaviors, food choices, nutrition, and health status. , 2001, The journal of nutrition, health & aging.

[16]  B. Astor,et al.  Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (1988-1994). , 2002, Archives of internal medicine.

[17]  C. McCulloch,et al.  Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey. , 2002, Journal of the American Society of Nephrology : JASN.

[18]  E. Rimon,et al.  Diagnosis of iron deficiency anemia in the elderly by transferrin receptor-ferritin index. , 2002, Archives of internal medicine.

[19]  M. Meriç,et al.  Iron Deficiency Anemia in the Elderly: Prevalence and Endoscopic Evaluation of the Gastrointestinal Tract in Outpatients , 2003, Acta Haematologica.

[20]  L. Balducci.  Epidemiology of Anemia in the Elderly: Information on Diagnostic Evaluation , 2003, Journal of the American Geriatrics Society.

[21]  R. Green,et al.  Update on cobalamin, folate, and homocysteine. , 2003, Hematology. American Society of Hematology. Education Program.

[22]  D. Fergusson,et al.  Mechanisms of Unexplained Anemia in the Nursing Home , 2004, Journal of the American Geriatrics Society.

[23]  L. Ferrucci,et al.  What Constitutes Normal Hemoglobin Concentration in Community‐Dwelling Disabled Older Women? , 2004, Journal of the American Geriatrics Society.

[24]  J. Craig,et al.  Renal impairment and anaemia in a population‐based study of older people , 2004, Internal medicine journal.

[25]  L. Ferrucci,et al.  Anemia Is Associated with Disability and Decreased Physical Performance and Muscle Strength in the Elderly , 2004, Journal of the American Geriatrics Society.

[26]  D. Fergusson,et al.  Prevalence of anemia in skilled-nursing home residents. , 2004, Archives of gerontology and geriatrics.

[27]  Luigi Ferrucci,et al.  Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. , 2004, Blood.

[28]  Mary Cushman,et al.  A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. , 2005, Archives of internal medicine.

[29]  L. Ferrucci,et al.  Renal function, erythropoietin, and anemia of older persons: the InCHIANTI study. , 2005, Archives of internal medicine.

[30]  Carol West,et al.  Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on hemoglobin levels and mean corpuscular volume. , 2005, Blood.

[31]  M. Løchen,et al.  Haemoglobin and anaemia in a gender perspective: The Tromsø Study * , 2005, European journal of haematology.

[32]  Jun Suk Kim,et al.  Incidence of anemia in older Koreans: community-based cohort study. , 2005, Archives of gerontology and geriatrics (Print).

[33]  L. Goodnough,et al.  Anemia of chronic disease. , 2005, The New England journal of medicine.

[34]  J. Guralnik,et al.  Anemia in old age is associated with increased mortality and hospitalization. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[35]  E. Beutler,et al.  The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? , 2006, Blood.

[36]  S. Bandinelli,et al.  Low testosterone levels and the risk of anemia in older men and women. , 2006, Archives of internal medicine.

[37]  M. Tonelli,et al.  Impact of anemia on hospitalization and mortality in older adults. , 2006, Blood.

[38]  H. Cohen,et al.  Impact of anemia on mortality, cognition, and function in community-dwelling elderly. , 2006, The American journal of medicine.

[39]  S. Bandinelli,et al.  Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers , 2007, British journal of haematology.

[40]  L. Kuller,et al.  Racial variation in the relationship of anemia with mortality and mobility disability among older adults. , 2007, Blood.

[41]  B. Culleton,et al.  Prevalence of Anemia in the Nursing Home: Contribution of Chronic Kidney Disease , 2007, Journal of the American Geriatrics Society.

[42]  G. Onder,et al.  Anemia status, hemoglobin concentration, and mortality in nursing home older residents. , 2007, Journal of the American Medical Directors Association.

[43]  S. Cummings,et al.  Kidney function and markers of inflammation in elderly persons without chronic kidney disease: the health, aging, and body composition study. , 2007, Kidney international.

[44]  S. Blum,et al.  Hematologic reference values for African American children and adolescents , 2007, American journal of hematology.

[45]  E. Estey,et al.  Epidemiology of myelodysplastic syndromes. , 2008, Seminars in hematology.

[46]  Anil K. Jain,et al.  Evaluation and long-term prognosis of new-onset, transient, and persistent anemia in ambulatory patients with chronic heart failure. , 2008, Journal of the American College of Cardiology.