Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Zeitschrift für Gerontologie und Geriatrie 8/2018

29.11.2018 | CME

Anämie im Alter

verfasst von: MPH PD Dr. Gabriele Röhrig

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Eine Anämie bei älteren Patienten stellt ein bis heute oft unterschätztes klinisches Problem dar. Allerdings konnten in den letzten Jahren durch zunehmende wissenschaftliche Auseinandersetzung mit dem Thema wichtige Einsichten gewonnen werden, die eine sehr differenzierte Einschätzung der Anämie beim älteren Patienten erlauben. So sind inzwischen sowohl die Multikausalität als auch komplexe negative Auswirkungen anerkannte Charakteristika der Anämie beim älteren Menschen, was zu der Diskussion geführt hat, die Anämie im Alter als geriatrisches Syndrom zu werten. Der vorliegende Beitrag gibt eine aktualisierte Übersicht über den Stand der Wissenschaft hinsichtlich dieses klinisch hoch relevanten Themas.
Literatur
1.
Zurück zum Zitat Andro M, Le Squere P, Estivin S, Gentric A (2013) Anaemia and cognitive performances in the elderly: a systematic review. Eur J Neurol 20(9):1234–1240 CrossRefPubMed Andro M, Le Squere P, Estivin S, Gentric A (2013) Anaemia and cognitive performances in the elderly: a systematic review. Eur J Neurol 20(9):1234–1240 CrossRefPubMed
2.
Zurück zum Zitat Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, Cushman MA (2005) A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med 165(19):2214–2220 CrossRefPubMed Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, Cushman MA (2005) A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med 165(19):2214–2220 CrossRefPubMed
3.
Zurück zum Zitat McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B (2009) Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr 12(4):444–454 CrossRefPubMed McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B (2009) Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr 12(4):444–454 CrossRefPubMed
6.
Zurück zum Zitat Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC (2004) Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 104(8):2263–2268 CrossRef Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC (2004) Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 104(8):2263–2268 CrossRef
7.
Zurück zum Zitat Röhrig G, Klossok W, Becker I, Benzing T, Schulz RJ (2014) Prevalence of anemia among elderly patients in an emergency room setting. Eur Geriatr Med 5(1):3–7 CrossRef Röhrig G, Klossok W, Becker I, Benzing T, Schulz RJ (2014) Prevalence of anemia among elderly patients in an emergency room setting. Eur Geriatr Med 5(1):3–7 CrossRef
8.
Zurück zum Zitat Zilinski J, Zillmann R, Becker I, Benzing T, Schulz RJ, Roehrig G (2014) Prevalence of anemia among elderly inpatients and its association with multidimensional loss of function. Ann Hematol 93(10):1645–1654 CrossRefPubMed Zilinski J, Zillmann R, Becker I, Benzing T, Schulz RJ, Roehrig G (2014) Prevalence of anemia among elderly inpatients and its association with multidimensional loss of function. Ann Hematol 93(10):1645–1654 CrossRefPubMed
9.
Zurück zum Zitat Röhrig G, Hörter M, Becker I, Adams A, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016a) Anemia and hematologic parameters in older patients: results of a German multicentric cross-sectional study. Eur Geriatr Med 7(4):328–332 CrossRef Röhrig G, Hörter M, Becker I, Adams A, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016a) Anemia and hematologic parameters in older patients: results of a German multicentric cross-sectional study. Eur Geriatr Med 7(4):328–332 CrossRef
12.
Zurück zum Zitat Beutler E, Waalen J (2006) The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 107(5):1747–1750 CrossRefPubMedPubMedCentral Beutler E, Waalen J (2006) The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 107(5):1747–1750 CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Owusu C, Cohen HJ, Feng T, Tew W, Mohile SG, Klepin HD, Gross CP, Gajra A, Lichtman SM, Hurria A, Cancer and Aging Research Group [CARG] (2015) Anemia and functional disability in older adults with cancer. J Natl Compr Canc Netw 13(10):1233–1239 CrossRefPubMedPubMedCentral Owusu C, Cohen HJ, Feng T, Tew W, Mohile SG, Klepin HD, Gross CP, Gajra A, Lichtman SM, Hurria A, Cancer and Aging Research Group [CARG] (2015) Anemia and functional disability in older adults with cancer. J Natl Compr Canc Netw 13(10):1233–1239 CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat World Health Organization (1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37 World Health Organization (1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37
16.
Zurück zum Zitat Thomas L (2005) Labor und Diagnose, 6. Aufl. TH-Books, Frankfurt a.M. Thomas L (2005) Labor und Diagnose, 6. Aufl. TH-Books, Frankfurt a.M.
17.
Zurück zum Zitat Wish JB (2006) Assessing iron status: beyond serum ferritin and transferrin saturation. Clin J Am Soc Nephrol 1(Suppl 1):S4–S8 CrossRefPubMed Wish JB (2006) Assessing iron status: beyond serum ferritin and transferrin saturation. Clin J Am Soc Nephrol 1(Suppl 1):S4–S8 CrossRefPubMed
18.
Zurück zum Zitat Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR (2006) Impact of anemia on hospitalization and mortality in older adults. Blood 107(10):3841–3846 CrossRefPubMed Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR (2006) Impact of anemia on hospitalization and mortality in older adults. Blood 107(10):3841–3846 CrossRefPubMed
19.
Zurück zum Zitat Ambayya A, Su AT, Osman NH, Nik-Samsudin NR, Khalid K, Chang KM et al (2014) Haematological reference intervals in a multiethnic population. PLoS ONE 9:e91968 CrossRefPubMedPubMedCentral Ambayya A, Su AT, Osman NH, Nik-Samsudin NR, Khalid K, Chang KM et al (2014) Haematological reference intervals in a multiethnic population. PLoS ONE 9:e91968 CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Patel KV, Semba RD, Ferrucci L, Newman AB, Fried LP, Wallace RB, Bandinelli S, Phillips CS, Yu B, Connelly S, Shlipak MG, Chaves PH, Launer LJ, Ershler WB, Harris TB, Longo DL, Guralnik JM (2010) Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci 65(3):258–265. https://​doi.​org/​10.​1093/​gerona/​glp163 CrossRefPubMed Patel KV, Semba RD, Ferrucci L, Newman AB, Fried LP, Wallace RB, Bandinelli S, Phillips CS, Yu B, Connelly S, Shlipak MG, Chaves PH, Launer LJ, Ershler WB, Harris TB, Longo DL, Guralnik JM (2010) Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci 65(3):258–265. https://​doi.​org/​10.​1093/​gerona/​glp163 CrossRefPubMed
24.
Zurück zum Zitat Cankurtaran M, Yavuz BB, Halil M, Ulger Z, Haznedaroğlu IC, Arıoğul C (2012) Increased ferritin levels could reflect ongoing aging-associated inflammation and may obscure underlying iron deficiency in the geriatric population. Eur Geriatr Med 3(5):277–280 CrossRef Cankurtaran M, Yavuz BB, Halil M, Ulger Z, Haznedaroğlu IC, Arıoğul C (2012) Increased ferritin levels could reflect ongoing aging-associated inflammation and may obscure underlying iron deficiency in the geriatric population. Eur Geriatr Med 3(5):277–280 CrossRef
27.
Zurück zum Zitat Polepalle T, Moogala S, Boggarapu S, Pesala DS, Palagi FB (2015) Acute phase proteins and their role in periodontitis: a review. J Clin Diagn Res 9(11):ZE1–ZE5 PubMedPubMedCentral Polepalle T, Moogala S, Boggarapu S, Pesala DS, Palagi FB (2015) Acute phase proteins and their role in periodontitis: a review. J Clin Diagn Res 9(11):ZE1–ZE5 PubMedPubMedCentral
31.
Zurück zum Zitat Maggio M, Lauretani F, Ceda GP, Bandinelli S, Ling SM, Metter EJ, Artoni A, Carassale L, Cazzato A, Ceresini G, Guralnik JM, Basaria S, Valenti G, Ferrucci L (2007) Relationship between low levels of anabolic hormones and 6‑year mortality in older men: the aging in the Chianti Area [InCHIANTI] study. Arch Intern Med 167(20):2249–2254 CrossRefPubMedPubMedCentral Maggio M, Lauretani F, Ceda GP, Bandinelli S, Ling SM, Metter EJ, Artoni A, Carassale L, Cazzato A, Ceresini G, Guralnik JM, Basaria S, Valenti G, Ferrucci L (2007) Relationship between low levels of anabolic hormones and 6‑year mortality in older men: the aging in the Chianti Area [InCHIANTI] study. Arch Intern Med 167(20):2249–2254 CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Röhrig G, Becker I, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016) Association between hematologic parameters and functional impairment among geriatric inpatients: data of a prospective cross-sectional multicenter study [“GeriPrävalenz2013”]. Maturitas 90:37–41 CrossRefPubMed Röhrig G, Becker I, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016) Association between hematologic parameters and functional impairment among geriatric inpatients: data of a prospective cross-sectional multicenter study [“GeriPrävalenz2013”]. Maturitas 90:37–41 CrossRefPubMed
35.
Zurück zum Zitat Romero-Ruperto S, Pérez-Bocanegra MC, Duran-Taberna M, Toscano-Rivera A, Barbé-Gil Ortega J, San José-Laporte A (2015) Anemia in elderly patients admitted to an acute geriatric ward. Rev Esp Geriatr Gerontol 50(3):122–125 CrossRefPubMed Romero-Ruperto S, Pérez-Bocanegra MC, Duran-Taberna M, Toscano-Rivera A, Barbé-Gil Ortega J, San José-Laporte A (2015) Anemia in elderly patients admitted to an acute geriatric ward. Rev Esp Geriatr Gerontol 50(3):122–125 CrossRefPubMed
37.
Zurück zum Zitat Röhrig G, Rücker Y, Becker I, Schulz RJ, Lenzen-Großimlinghaus R, Willschrei P, Gebauer S, Modreker M, Jäger M, Wirth R (2017) Association of anemia with functional and nutritional status in the German multicenter study “GeriAnaemie2013”. Z Gerontol Geriatr 50(6):532–537 CrossRefPubMed Röhrig G, Rücker Y, Becker I, Schulz RJ, Lenzen-Großimlinghaus R, Willschrei P, Gebauer S, Modreker M, Jäger M, Wirth R (2017) Association of anemia with functional and nutritional status in the German multicenter study “GeriAnaemie2013”. Z Gerontol Geriatr 50(6):532–537 CrossRefPubMed
39.
Zurück zum Zitat Zamboni V, Cesari M, Zuccalà G, Onder G, Woodman RC, Maraldi C, Ranzini M, Volpato S, Pahor M, Bernabei R (2006) Anemia and cognitive performance in hospitalized older patients: results from the GIFA study. Int J Geriatr Psychiatry 21(6):529–534 CrossRefPubMed Zamboni V, Cesari M, Zuccalà G, Onder G, Woodman RC, Maraldi C, Ranzini M, Volpato S, Pahor M, Bernabei R (2006) Anemia and cognitive performance in hospitalized older patients: results from the GIFA study. Int J Geriatr Psychiatry 21(6):529–534 CrossRefPubMed
40.
Zurück zum Zitat Umegaki H, Yanagawa M, Endo H (2011) Association of lower hemoglobin level with depressive mood in elderly women at high risk of requiring care. Geriatr Gerontol Int 11(3):262–266 CrossRefPubMed Umegaki H, Yanagawa M, Endo H (2011) Association of lower hemoglobin level with depressive mood in elderly women at high risk of requiring care. Geriatr Gerontol Int 11(3):262–266 CrossRefPubMed
41.
Zurück zum Zitat Trevisan C et al (2016) Low hemoglobin levels and risk of developing depression in the elderly: results from the prospective PRO.V.A. Study. J Clin Psychiatry 77(12):e1549–e1556 CrossRefPubMed Trevisan C et al (2016) Low hemoglobin levels and risk of developing depression in the elderly: results from the prospective PRO.V.A. Study. J Clin Psychiatry 77(12):e1549–e1556 CrossRefPubMed
44.
Zurück zum Zitat Röhrig G, Steinmetz T, Stein J, Geisel T, Virgin G, Schaefer R, Bach M, Schulz RJ (2014) Efficacy and tolerability of ferric carboxymaltose in geriatric patients with anemia. Data from three non-interventional studies. MMW Fortschr Med 156(Suppl 2):48–53 CrossRefPubMed Röhrig G, Steinmetz T, Stein J, Geisel T, Virgin G, Schaefer R, Bach M, Schulz RJ (2014) Efficacy and tolerability of ferric carboxymaltose in geriatric patients with anemia. Data from three non-interventional studies. MMW Fortschr Med 156(Suppl 2):48–53 CrossRefPubMed
45.
Zurück zum Zitat Röhrig G, Nobbe C, Weiß V, Schulz RJ (2013) Hepcidin in anaemic geriatric patients with non-dialysis chronic kidney disease (ND-CKD). Eur Geriatr Med 4(4):221–225 CrossRef Röhrig G, Nobbe C, Weiß V, Schulz RJ (2013) Hepcidin in anaemic geriatric patients with non-dialysis chronic kidney disease (ND-CKD). Eur Geriatr Med 4(4):221–225 CrossRef
46.
Zurück zum Zitat Zaritsky J, Young B, Wang HJ, Westerman M, Olbina G, Nemeth E et al (2009) Hepcidin — a potential novel biomarker for iron status in chronic kidney disease. Clin J Am Soc Nephrol 4:1051–1056 CrossRefPubMedPubMedCentral Zaritsky J, Young B, Wang HJ, Westerman M, Olbina G, Nemeth E et al (2009) Hepcidin — a potential novel biomarker for iron status in chronic kidney disease. Clin J Am Soc Nephrol 4:1051–1056 CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Dahlerup JF, Eivindson M, Jacobsen BA, Jensen NM, Jørgensen SP, Laursen SB, Rasmussen M, Nathan T (2015) Diagnosis and treatment of unexplained anemia with iron deficiency without overt bleeding. Dan Med J 62(4):C5072 PubMed Dahlerup JF, Eivindson M, Jacobsen BA, Jensen NM, Jørgensen SP, Laursen SB, Rasmussen M, Nathan T (2015) Diagnosis and treatment of unexplained anemia with iron deficiency without overt bleeding. Dan Med J 62(4):C5072 PubMed
48.
Zurück zum Zitat Poetes J (1954) Oral iron therapy in hemorrhagic, infectious and tumorous anemias. Hippokrates 25(20):651–652 PubMed Poetes J (1954) Oral iron therapy in hemorrhagic, infectious and tumorous anemias. Hippokrates 25(20):651–652 PubMed
49.
Zurück zum Zitat Kulaksiz H, Theilig F, Bachmann S, Gehrke SG, Rost D, Janetzko A, Cetin Y, Stremmel W (2005) The iron-regulatory peptide hormone hepcidin: expression and cellular localization in the mammalian kidney. J Endocrinol 184(2):361–370 CrossRefPubMed Kulaksiz H, Theilig F, Bachmann S, Gehrke SG, Rost D, Janetzko A, Cetin Y, Stremmel W (2005) The iron-regulatory peptide hormone hepcidin: expression and cellular localization in the mammalian kidney. J Endocrinol 184(2):361–370 CrossRefPubMed
50.
Zurück zum Zitat Nemeth E, Valore EV, Territo M, Schiller G, Lichtenstein A, Ganz T (2003) Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood 101(7):2461–2463 CrossRefPubMed Nemeth E, Valore EV, Territo M, Schiller G, Lichtenstein A, Ganz T (2003) Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood 101(7):2461–2463 CrossRefPubMed
52.
Zurück zum Zitat Bach M, Geisel T, Martin J, Schulze B, Schaefer R, Virgin G, Stein J (2015) Efficacy and safety of intravenous ferric carboxymaltose in geriatric inpatients at a German tertiary university teaching hospital: a retrospective observational cohort study of clinical practice. Anemia 2015:647930 CrossRefPubMedPubMedCentral Bach M, Geisel T, Martin J, Schulze B, Schaefer R, Virgin G, Stein J (2015) Efficacy and safety of intravenous ferric carboxymaltose in geriatric inpatients at a German tertiary university teaching hospital: a retrospective observational cohort study of clinical practice. Anemia 2015:647930 CrossRefPubMedPubMedCentral
53.
Zurück zum Zitat Reed J, Charytan C, Yee J (2007) The safety of intravenous iron sucrose use in the elderly patient. Consult Pharm 22(3):230–238 CrossRefPubMed Reed J, Charytan C, Yee J (2007) The safety of intravenous iron sucrose use in the elderly patient. Consult Pharm 22(3):230–238 CrossRefPubMed
54.
Zurück zum Zitat Tay HS, Soiza RL (2015) Systematic review and meta-analysis: what is the evidence for oral iron supplementation in treating anaemia in elderly people? Drugs Aging 32(2):149–158 CrossRefPubMed Tay HS, Soiza RL (2015) Systematic review and meta-analysis: what is the evidence for oral iron supplementation in treating anaemia in elderly people? Drugs Aging 32(2):149–158 CrossRefPubMed
55.
Zurück zum Zitat Silay K, Akinci S, Yalcin A, Guney T, Ulas A, Ozer O, Ozbek S, Dilek I (2015) The status of iron absorption in older patients with iron deficiency anemia. Eur Rev Med Pharmacol Sci 19(17):3142–3145 PubMed Silay K, Akinci S, Yalcin A, Guney T, Ulas A, Ozer O, Ozbek S, Dilek I (2015) The status of iron absorption in older patients with iron deficiency anemia. Eur Rev Med Pharmacol Sci 19(17):3142–3145 PubMed
57.
Zurück zum Zitat Aapro MS et al (2006) Epoetin alfa increases hemoglobin levels and improves quality of life in anemic geriatric cancer patients receiving chemotherapy. Support Care Cancer 14(12):1184–1194 CrossRefPubMed Aapro MS et al (2006) Epoetin alfa increases hemoglobin levels and improves quality of life in anemic geriatric cancer patients receiving chemotherapy. Support Care Cancer 14(12):1184–1194 CrossRefPubMed
59.
Zurück zum Zitat Bundesärztekammer (2014) Kapitel 1. In: Leitlinien der Bundesärztekammer zur Therapie mit Blutkomponenten und Plasma Derivaten, 4. Aufl. Deutscher Ärzteverlag, Köln, S 10–19 Bundesärztekammer (2014) Kapitel 1. In: Leitlinien der Bundesärztekammer zur Therapie mit Blutkomponenten und Plasma Derivaten, 4. Aufl. Deutscher Ärzteverlag, Köln, S 10–19
61.
Zurück zum Zitat Carson JL, Sieber F, Cook DR, Hoover DR, Noveck H, Chaitman BR, Fleisher L, Beaupre L, Macaulay W, Rhoads GG, Paris B, Zagorin A, Sanders DW, Zakriya KJ, Magaziner J (2015) Liberal versus restrictive blood transfusion strategy: 3‑year survival and cause of death results from the FOCUS randomised controlled trial. Lancet 385(9974):1183–1189. https://​doi.​org/​10.​1016/​S0140-6736(14)62286-8 CrossRef Carson JL, Sieber F, Cook DR, Hoover DR, Noveck H, Chaitman BR, Fleisher L, Beaupre L, Macaulay W, Rhoads GG, Paris B, Zagorin A, Sanders DW, Zakriya KJ, Magaziner J (2015) Liberal versus restrictive blood transfusion strategy: 3‑year survival and cause of death results from the FOCUS randomised controlled trial. Lancet 385(9974):1183–1189. https://​doi.​org/​10.​1016/​S0140-6736(14)62286-8 CrossRef
Metadaten
Titel
Anämie im Alter
verfasst von
MPH PD Dr. Gabriele Röhrig
Publikationsdatum
29.11.2018
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 8/2018
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-018-01479-y