Iron status and anemia in the elderly: new findings and a review of previous studies.

Abstract

Iron status was determined in 280 free-living and healthy elderly men (n = 131) and women (n = 149) by assessing dietary and supplemental iron intake as well as ten biochemical measures of iron nutriture (erythrocyte count, hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, plasma iron level, total iron-binding capacity, per cent transferrin saturation, and ferritin level). Subject ages ranged from 60 to 93 years with a median age of 72 years for both women and men. For comparison purposes, iron status measures in an unselected group of younger men (n = 107) and women (n = 164) between the ages of 20 and 39 years were also obtained. None of the elderly women and only two (1.2 per cent) of the younger women had low hemoglobin levels (less than 12.0 g/dl). Three (2.3 per cent) of the elderly men and none of the younger men had low hemoglobin levels (less than 14 g/dl). Other iron status measures revealed that anemia or iron deficiency was no more prevalent in the healthy elderly population than in the younger adult population when identical criteria were used to assess iron nutriture. The genesis of anemia often seen in the elderly is not completely understood. Reported evidence suggests the presence of anemia in the elderly is a result of overall reduction of hematopoietic reserves. Because of the potentially serious consequences of this assumption about anemia to the treatment of the elderly, the authors critically review some of the studies that have been designed in the past to determine the prevalence and etiology of anemia in the aged. They suggest that health status, race, socioeconomic status, diet, and region are more important than age as explanations for the high prevalence of anemia seen in many previous studies.