Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia
Open accessAbstract
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.”
From Red Blood Cell Function and Dysfunction: Redox Regulation, Nitric Oxide Metabolism, Anemia (2017) · cites this paper as [77]
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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
- Publisher
- American Society of Hematology
- 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
- bronze
- doi.org
- 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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