Prevalence of anemia in elderly subjects living at home: role of micronutrient deficiency and inflammation

Objective: Aging is associated with increased risk of developing anemia and micronutrient deficiencies. Wheat-based staple foods are iron fortified in Chile. We aimed to establish the prevalence and etiology of anemia in apparently healthy free-living elderly subjects. Design and setting: A cross-sectional study was performed in an outpatient clinic of Santiago, Chile. Subjects and methods: A group of 274 subjects (93 men, 181 women) greater than or equal to 60 y old living at home and apparently healthy was studied. Clinical and anthropometric evaluations and dietary survey were performed. Complete blood count, and status of iron, copper, folate, vitamins B-12 and A and C-reactive protein, and erythrocyte sedimentation rate were measured. Results: Prevalence of anemia was 5.4% for men and 4.4% for women. Subjects with inflammatory process had a higher prevalence of anemia (22.2% men, 31.6% women). Abnormal serum retinol (< 0.35 <mu>mol/l) was found in 13.7% of men and 15.9% of women. Prevalence of folate deficiency (< 7 nmol/l) was 50.5% in men and 33.1% in women. Low serum vitamin B-12 (< 148 pmol/l) was present in 51.1% of men and 30.9% of women. Iron and copper deficiencies were infrequent. Conclusions: Anemia is not prevalent in free-living elderly subjects when iron intake is adequate. Inflammatory process is the main etiology of anemia in this age group. Vitamin A, folate and vitamin B-12 deficiencies were found in a significant proportion of the study group.