NEW YORK, May 11 (Reuters Health) -- Anemia is common among the elderly and may indicate serious underlying illness, according to researchers.
The study results also indicate that the risk of death for anemic individuals over 85 years of age is twice as high as the mortality risk found in people of the same age who do not have anemia, report Dr. Gerbrand Izaks and colleagues at Leiden University Medical Center in Leiden, the Netherlands. Their findings are published in the May 12th issue of The Journal of the American Medical Association.
Anemia is caused by a deficiency of hemoglobin -- iron-laden blood pigments that help transport oxygen throughout the circulatory system.
The study authors used World Health Organization (WHO) criteria to establish levels of anemia in 755 community-dwelling Dutch individuals over the age of 85. They then tracked rates of illness and death among these subjects over 10 years of follow-up.
"Anemia was found in 17% of the women and in 28% of the men," the authors report.
Anemia was associated with a higher risk for death from all causes among the group studied, according to the researchers. Compared with people who were not anemic, women with anemia had a 60% higher risk for death, while the death risk for anemic men rose more than two-fold (2.29).
Over the 10-year study, 86% of the people with anemia died, compared with 65% of those with normal hemoglobin concentrations.
"Malignant neoplasms and infections were more often noted as the primary cause of death in persons with anemia, whereas respiratory diseases were more often noted as the primary cause of death in persons with a normal hemoglobin concentration," according to the investigators.
The research team found that 13% of anemic persons had cancer during the 10-years of follow-up, compared with just 5% of the group who were not anemic. Elderly subjects with anemia also had higher rates of peptic ulcers and infections compared with non-anemic subjects.
Izaks and colleagues write that "anemia in older persons is due to disease and not to aging."
"A cause for anemia is found in most older persons with a low hemoglobin concentration," they add.
Based on these findings, the Dutch researchers advise that anemia be viewed as a marker for underlying illness in the elderly. "Further clinical investigation is warranted if an older person's hemoglobin concentration is below the WHO normal values -- even if the person is without apparent clinical disease," they conclude.
WHO defines normal levels of hemoglobin concentration at 7.5 to 10.0 mmol/L in women and 8.1 to 11.2 mmol/L in men.
SOURCE: The Journal of the American Medical Association 1999;281:1714-1717.
