Anaemia of chronic disease is the most common form of anaemia in the elderly and occurs because of underlying systemic inflammation. It is diagnosed by an elevated ferritin level and is difficult to treat.
Anaemia of chronic kidney disease occurs because of the comorbid conditions of systemic inflammation and renal impairment. It can be managed with erythropoietic agents and, often, iron supplementation.
References
1 1. Nutritional anaemias. Report of a WHO scientific group. Geneva, World Health Organization, 1968. WHO Technical Report Series, No. 405. Accessed 24 December 2019. http://whqlibdoc.who.int/trs/WHO_TRS_405.pdf.
2 2. Wouters HJCM, van der Klauw MM, de Witte T, et al. Association of anaemia with health‐related quality of life and survival: a large population‐based cohort study. Haematologica. 2019; 104(3):468‐76.
3 3. Den Elzen WP, Willems JM, Westendorp RG, et al. Effect of anemia and comorbidity on functional status and mortality in old age: results from the Leiden 85‐plus study. CMAJ. 2009; 181:151‐57.
4 4. Balducci L. Anemia, fatigue and aging. Transfus Clin Biol. 2010; 17:375‐81.
5 5. Ruan Y, Guo Y, Kowal P, et al. Association between anemia and frailty in 13,175 community‐dwelling adults aged 50 years and older in China. BMC Geriatr. 2019; 19(1):327. Doi: 10.1186/s12877‐01901342‐5.
6 6. Qin T, Yan M, Fu Z, et al. Association between anemia and cognitive decline among Chinese middle‐aged and elderly: evidence from the China health and retirement longitudinal study. BMC Geriatr. 2019; 19(1):305. Doi: 10.1186/s12877‐01901308‐7.
7 7. Valderrabano RJ, Lee J, Lui LY, et al. Older men with anemia have increased fracture risk independent of bone mineral density. J Clin Endocrinol Metab. 2017; 102(7):2199‐2206.
8 8. Culleton BF, Manns BJ, Zhang J, et al. Impact of anemia on hospitalization and mortality in older adults. Blood. 2006; 107(10):3841‐46.
9 9. Riva E, Tettamanti M, Mosconi P, et al. Association of mild anemia with hospitalization and mortality in the elderly: the Health and Anemia population‐based study. Haematologica. 2009; 94(1):22‐28.
10 10. Guralnik JM, Eisenstaedt RS, Ferrucci L, et al. Prevalence of anemia in person 65 years and older in the United States: evidence of a high rate of unexplained anemia. Blood. 2004; 104(8):2263‐68.
11 11. Gaskell H, Derry S, Andrew Moore R, et al. Prevalence of anaemia in older persons: systematic review. BMC Geriatr. 2008; 8:1.Doi:10.1186/1471‐2318‐8‐1.
12 12. Stauder R, Thein SL. Anemia in the elderly: clinical implications and new therapeutic concepts. Haematologica. 2014; 99(7):1127‐30.
13 13. Bach V, Schruckmayer G, Sam I, et al. Prevalence and possible causes of anemia in the elderly: a cross‐sectional analysis of a large European university hospital cohort. Clin Interv Aging. 2014; 9:1187‐96.
14 14. Johnson‐Wimbley TD, Graham DY. Diagnosis and management of iron deficiency anemia in the 21st century. Therap Adv Gastroenterol. 2011; 4(3):177‐84.
15 15. Sanford AM. Anorexia of aging and its role for frailty. Curr Opin Clin Nutr Metab Care. 2017; 20(1):54‐60.
16 16. Sarzynski E, Puttarajappa C, Xie Y, et al. Association between proton pump inhibitor use and anemia: a retrospective cohort study. Dig Dis Sc. 2011; 56(8):2349‐53.
17 17. Abbaspour N, Hurrell R, and Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014; 19(2):164‐74.
18 18. Bunn HF, Heeney MM. Pathophysiology of Blood Disorders. 2011. Accessed 1 Jan 2020. https://accessmedicine.mhmedical.com/content.aspx?bookid=1900§ionid=137394788.
19 19. Ioannou G, Spector J, Scott K, et al. Prospective evaluation of a clinical guideline for the diagnosis and management of iron deficiency anemia. Am J Med. 2002; 113(4):281‐287.
20 20. Mast A, Blinder M, Gronowski A, et al. Clinical utility of the soluble transferrin receptor and comparison with serum ferritin in several populations. Clin Chem. 1998; 44(1):45‐51.
21 21. Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician. 2013; 87(2):98‐104.
22 22. O’Neil‐cutting M, Crosby W. Blocking of iron absorption by a preliminary oral dose of iron. Arch Intern Med. 1987; 147(3):489‐91
23 23. Rimon E, Kagansky N, Kagansky M, et al. Are we giving too much iron? Low‐dose iron therapy is effective in octogenarians. Am J Med. 2005; 118:1142‐47.
24 24. Hurrell RF, Reddy M, Cook JD. Inhibition of non‐haem iron absorption in man by polyphenolic‐containing beverages. Br J Nutr. 1999: 81:289‐95.
25 25. Morck TA, Cook JD. Factors affecting the bioavailability of dietary iron. Cereal Food World. 1981; 26(12):667‐72.
26 26. Liu K, Kaffes AJ. Iron deficiency anemia: a review of diagnosis, investigation, and management. Eur J Gastroenterol Hepatol. 2012; 24(2):109‐16.
27 27. Ioannou GN, Rockey DC, Bryson CL, et al. Iron deficiency and gastrointestinal malignancy: a population‐based cohort study. Am J Med. 2002; 113(4):276‐80.
28 28. Love AL, Billett HH. Obesity, bariatric surgery, and iron deficiency: true, true, true and related. Am J Hematol. 2008; 83(5):403‐9.
29 29. Baik H, Russell R. Vitamin B12 deficiency in the elderly. Annu Rev Nutr. 1999; 19:357‐77.
30 30. Lindenbaum J, Rosenberg IH, Wilson PW et al. Prevalence of cobalamin deficiency in the Gramingham elderly population. Am J Clin Nutr. 1994; 60:2‐11.
31 31. Clarke R, Grimley EValns, J, Schneede J, et al. Vitamin B12 and folate deficiency in later life. Age Ageing. 2004; 33:34‐41.
32 32. Pfisterer K, Sharratt M, Heckman G, et al. Vitamin B12 status in older adults living in Ontario long‐term care homes: prevalence and incidence of deficiency with supplementation as a protective factor. Appl physiol Nutr Metab. 2016; 41(2):219‐22.
33 33. De Jager J, Kooy A, Lehert P, et al. Long‐term treatment with metformin in patients with type 2 diabetes and risk of vitamin B12 deficiency: randomized placebo‐controlled trial. BMJ. 2010; 340:c2181.
34 34. Carmel R. Current concepts in cobalamin deficiency. Annu Rev Med. 2000; 51:357‐75.
35 35. Loukili NH, Noel E, Blaison G, et al. Update of pernicious anemia: a retrospective study of 49 cases. Rev Med Interne. 2004; 25:556‐61.
36 36. Nagao T, Hirokawa M. Diagnosis and treatment of macrocytic anemias in adults. J Gen Fam Med. 2017; 18(5):200‐204.
37 37. Savage DG, Lindenbaum J, Stabler SP, et al. Sensitvitiy of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. Am J Med. 1994; 96(3):239‐46.
38 38. Langan R, Zawistoski K. Update on Vitamin B12 Deficiency. Am Fam Physician. 2011; 83(12):1425‐30.
39 39. Wong CW. Vitamin B12 deficiency in the elderly: is it worth screening? Hong Kong Med J. 20015; 21:155‐64.
40 40. Carmel R. Green R, Rosenblatt DS, et al. Update on cobalamin, folate, and homocysteine. Hematology Am Soc Hematol Educ Program. 2003:62‐81.
41 41. Carmel R. Cobalamin, the stomach, and aging. Am J Clin Nutr. 1997; 66:750‐9.
42 42. Vidal‐Alaball J, Butler C, Cannings‐John R, et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cocahrane Database Syst Rev. 2005;(3):CD004655.
43 43.