Cited by 1,450Iron Metabolism and DisordersHematological disorders and diagnosticsErythropoietin and Anemia Treatment

Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia

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Guralnik, Jack M., Eisenstaedt, Richard S., Ferrucci, Luigi, Klein, Harvey G., Woodman, Richard C.·2004·Blood

Abstract

Clinicians frequently identify anemia in their older patients, but national data on the prevalence and causes of anemia in this population in the United States have been unavailable. Data presented here are from the noninstitutionalized US population assessed in the third National Health and Nutrition Examination Survey (1988-1994). Anemia was defined by World Health Organization criteria; causes of anemia included iron, folate, and B12 deficiencies, renal insufficiency, anemia of chronic inflammation (ACI), formerly termed anemia of chronic disease, and unexplained anemia (UA). ACI by definition required normal iron stores with low circulating iron (less than 60 μg/dL). After age 50 years, anemia prevalence rates rose rapidly, to a rate greater than 20% at age 85 and older. Overall, 11.0% of men and 10.2% of women 65 years and older were anemic. Of older persons with anemia, evidence of nutrient deficiency was present in one third, ACI or chronic renal disease or both was present in one third, and UA was present in one third. Most occurrences of anemia were mild; 2.8% of women and 1.6% of men had hemoglobin levels lower than 110 g/L (11 g/dL). Therefore, anemia is common, albeit not severe, in the older population, and a substantial proportion of anemia is of indeterminate cause. The impact of anemia on quality of life, recovery from illness, and functional abilities must be further investigated in older persons.

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  • A high percentage (almost 30%) of elderly patients with CVD exhibit idiopathic anemia.

    “Moreover, a high percentage (almost 30%) of these patients exhibit idiopathic anemia (77) that may be caused by blood loss due to repetitive blood tests and surgical interventions, as well as occult bleeding (mainly in the gastrointestinal tract) during hospitalization.”

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Research works printed but not linked: 3

  1. Korn EL, Graubard BI. Epidemiologic studies uti- lizing surveys: accounting for the sampling de- sign. Am J Public Health. 1991;81:1166-1173.
  2. Smith D. Management and treatment of anemia in the elderly. Clin Geriatr. 2002;10:47-53.
  3. Chua E, Clague JE, Sharma AK, Horan MA, Lom- bard M. Serum tranferrin receptor assay in iron deficiency anaemia and anaemia of chronc dis- ease in the elderly. Q J Med. 1999;92:587-594.

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Authors
Guralnik, J. M., Eisenstaedt, R. S., Ferrucci, L., Klein, H. G., & Woodman, R. C.
Affiliations
National Institutes of Health (US)
Venue
Blood
Published
2004-10-15
Volume
104
Issue
8
Pages
2263-2268
ISSN
  • 0006-4971 (ISSN-L)
  • 1528-0020
OpenAlex
W2155296700
Cited by
1,450
References
46
Citations by year
2026: 27 · 2025: 56 · 2024: 59 · 2023: 73 · 2022: 65 · 2021: 85 · 2020: 87 · 2019: 90 · 2018: 78 · 2017: 73 · 2016: 84 · 2015: 97 · 2014: 77 · 2013: 73 · 2012: 72
FWCI
22.37
Type
journal article
Language
en
Open access
Locations
  • Blood (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Health Sciences › Medicine › Emergency Medicine › Hematological disorders and diagnostics
  • Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
Keywords
anemia, older adults, prevalence, unexplained anemia, anemia of chronic disease, iron deficiency, folate deficiency, vitamin B12 deficiency, renal failure, chronic kidney disease, hemoglobin levels, NHANES III, quality of life
MeSH terms
Age Factors, Aged, Anemia, Ethnicity, Female, Hemoglobins, Humans, Male, Sex Characteristics, United States, Prevalence

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