Mechanisms of Unexplained Anemia in the Nursing Home

Artz, Andrew S.; Fergusson, Dean; Drinka, Paul J.; Gerald, Melvin; Bidenbender, Rex; Lechich, Anthony J.; Silverstone, Felix A.; McCamish, Mark; Dai, Jinlu; Keller, Evan T.; Ershler, William B.

doi:10.1111/j.1532-5415.2004.52116.x

Cited by 106 publications

(79 citation statements)

References 27 publications

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“…However, since the prevalences of the different pathophysiological forms of anaemia, particularly the prevalence of unexplained anaemia, are remarkably similar to those reported by other studies (Artz et al, 2004;Guralnik et al, 2004), we are confident that our findings have strong external validity. In fact, not only was our study performed on a representative sample of the older population in the community, but also the different forms of anaemia were classified using measures and criteria that, with the exception of bone marrow inspection, are considered state of the art in clinical practice.…”

Section: ·2 1·1supporting

confidence: 74%

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Ferrucci

Guralnik

Bandinelli³

et al. 2007

Br J Haematol

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125

102

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SummaryEpidemiological studies report that a third of the cases of anaemia in older persons is unexplained. We compared erythropoietin (EPO), inflammatory markers and major comorbidities between older subjects with normal haemoglobin levels and those with different aetiologic forms of anaemia, including unexplained anaemia. Participants were a representative sample of 964 persons aged ≥65 years, with no evidence of bleeding, complete blood tests, and a complete blood count within 6 h of phlebotomy. Anaemia was defined as haemoglobin <130 g/l in men and 120 g/l in women, and classified as a result of chronic kidney disease, iron deficiency, chronic disease and B12/folate deficiency anaemia, or unexplained anaemia based on standard criteria. Of the 124 anaemic participants, 42 (36·8%) had unexplained anaemia. Participants with anaemia of chronic diseases had significantly higher interleukin‐6 (IL‐6) and C‐reactive protein (CRP) levels, while those with unexplained anaemia had significantly lower CRP than non‐anaemic controls. Iron deficiency anaemia was characterised by significantly higher EPO levels compared with other types of anaemia and normal haemoglobin, B12 and/or folate deficiency. Unexplained anaemia was characterised by unexpectedly low EPO and low lymphocyte count. Unexplained anaemia is associated with reduced kidney EPO response, low levels of pro‐inflammatory markers and low lymphocyte counts.

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Section: ·2 1·1supporting

confidence: 74%

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Ferrucci

Guralnik

Bandinelli³

et al. 2007

Br J Haematol

Self Cite

125

102

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“…The significance of this type of anemia is presently unknown, but it is probably a myelodysplastic syndrome. [22] Finally, it may be noted that our study revealed that not all subjects with microcytic blood picture were iron deficient which may be due to thalassaemia, sideroblastic anaemia or falsely raised ferritin concentrations. Also, cut off points for ferritin have been questioned, as iron deficient erythropoiesis can occur in elderly with ferritin levels at a higher cut off value than the younger population.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia and Micronutrient Deficiency in Elderly

Kaur¹,

Piplani²,

Madan³

et al. 2014

IJMDS

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“…Artz et al 14 showed that 14% to 50% of anemic elderly had no obvious underlying cause. In our study, 22% had IDA, 10% B12 / folate deficiency.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and pattern of anemia in elderly- A hospital based study

Bisht¹,

Sofia²,

Neki³

2017

Int. J. Curr. Res. Med. Sci.

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Anemia in the elderly is an extremely common problem that is associated with increased mortality and poorer health-related quality of life, regardless of the underlying cause of the low hemoglobin. A cross sectional study was conducted in the Department of Pathology, Assam Medical College and Hospital, Dibrugarh, in collaboration with the Department of Medicine . The purpose of this study was to study the prevalence of elderly patients with anemia and to study the pattern of anemia in such patients as well as the closest possible etiological profile. Prevalence calculated was 77% .Hundred patients above the age of 60 years were included for studying the pattern of anemia. Clinical profile with laboratory studies of Hemoglobin and diagnostic tests were done to know the etiology. Majority of patients had normocytic blood picture constituting 53%, microcytic 26%, macrocytic/dimorphic 13% and pancytopenia in 8%.Anemia of chronic disease was the commonest cause of anemia followed by iron deficiency anemia. 53/100 patients had normocytic blood picture .45 out of 53 patients had serum ferritin levels more than 100ng/ml. 13/26 of cases showing microcytic anemia had ferritin levels <20ng/ml and 5/26 had no evidence of iron deficiency have ferritin values >100ng/ml. None of the cases with macrocytic anemia and pancytopenia had serum ferritin values <100ng/ml. This shows that serum ferritin closely correlates with iron stores. Absence of iron capable of being stained by pearls stain is considered to be a reliable parameter of iron deficiency. Serum ferritin together with pearls stain in bone marrow is considered to be a reliable parameter of iron deficiency anemia. Confirming the type of anemia is critical to direct the investigation for profiling the etiology since it is well known that the treatment of anemia goes a long way in improving the overall outcome and quality of life.

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Mechanisms of Unexplained Anemia in the Nursing Home

Abstract: IA is common in nursing home residents. A lower EPO response contributes to the high prevalence of anemia in this setting and may be due, in part, to occult renal dysfunction.

Cited by 106 publications

References 27 publications

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro‐inflammatory markers

Prevalence of Anemia and Micronutrient Deficiency in Elderly

Prevalence and pattern of anemia in elderly- A hospital based study

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