Abstract
Anemia in the aged is a frequent but still under-estimated problem in geriatric patients. However, in recent years increasing research on anemia in the aged has improved awareness and interest in this clinically relevant problem. Guidelines for diagnostic and therapeutic steps are now required to improve the treatment of anemic aged patients. For encouraging the development of diagnostic and therapeutic recommendations, the “working group anemia” of the German Geriatric Society (DGG) has issued a position paper on anemia in the aged, based on the current literature. The statements are (1) that anemia has to be considered a highly prevalent but not a physiologic finding in aged persons; (2) that reference values for hemoglobin concentration are independent of age, indicating that WHO reference values for anemia definition are valid for aged persons; (3) that anemia in the aged is associated with functional and cognitive impairment based on comprehensive geriatric assessment (CGA), requiring diagnosis and treatment.
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References
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. https://doi.org/10.1111/ene.12175
Bach V, Schruckmayer G, Sam I, Kemmler G, Stauder R (2014) Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Clin Interv Aging 22(9):1187–1196. https://doi.org/10.2147/CIA.S61125
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
Contreras M, Formiga F, Ferrer A, Chivite D, Padrós G, Montero A, Grupo Octabaix (2015) Profile and prognosis of patients over 85 years old with anemia living in the community. Octabaix Study. Rev Esp Geriatr Gerontol 50(5):211–215. https://doi.org/10.1016/j.regg.2014.11.004
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
Gaskell H, Derry S, Andrew Moore R, McQuay HJ (2008) Prevalence of anaemia in older persons: systematic review. BMC Geriatr 14(8):1. https://doi.org/10.1186/1471-2318-8-1
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
Hastka J, Heimpel H, Metzgeroth G (2011) Iron deficiency and iron deficiency anemia (Eisenmangel und Eisenmangelanämie) Onkopedia guideline: https://www.onkopedia.com/de/onkopedia/guidelines/eisenmangel-und-eisenmangelanaemie. Accessed 20 Jan 2018
Hong CH, Falvey C, Harris TB, Simonsick EM, Satterfield S, Ferrucci L, Metti AL, Patel KV, Yaffe K (2013) Anemia and risk of dementia in older adults: findings from the Health ABC study. Neurology 81(6):528–533
Leischker A, Fetcher S, Kolb GF (2016) Anaemia in the elderly. Dtsch Med Wochenschr 141(13):954–959
Röhrig G, Schulz RJ (2012) Anemia in the elderly. Urgent need for guidelines. Z Gerontol Geriatr 45(3):182–185
Röhrig G, Becker I, Schulz RJ, Lenzen-Großimlinghaus R, Willschrei P, Gebauer S, Modreker M, Jäger M, 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. https://doi.org/10.1016/j.maturitas.2016.04.020
Röhrig G, Hörter M, Becker I, Adams A, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016) Anemia and hematologic parameters in older patients: results of a German multicentric cross-sectional study. Eur Geriat Med 7(4):328–332
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
Röhrig G, Becker I, Gutensohn K, Nebe T. Red blood cell counts and indices in the elderly German population. Accepted by Journal of Laboratory Medicine No. JLM.2017.0080.R2 on 4.11.2017
Saad F, Röhrig G, von Haehling S, Traish A (2017) Testosterone deficiency and testosterone treatment in older men. Gerontology 63(2):144–156
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. https://doi.org/10.1016/j.regg.2014.09.002
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. https://doi.org/10.1111/j.1447-0594.2010.00672x
World Health Organization (1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37
Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, Cushman M (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
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
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. https://doi.org/10.1007/s00277-014-2110-4
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Röhrig, G., Gütgemann, I., Kolb, G. et al. Anemia in the aged is not ageing related: position paper on anemia in the aged by the “working group anemia” of the German Geriatric Society (DGG). Eur Geriatr Med 9, 395–397 (2018). https://doi.org/10.1007/s41999-018-0048-0
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DOI: https://doi.org/10.1007/s41999-018-0048-0