Anemia: An indicator for malnutrition in the elderly

被引：91
作者：
Mitrache C. [1 ]
Passweg J.R. [1 ]
Libura J. [1 ]
Petrikkos L. [1 ]
Seiler W.O. [2 ]
Gratwohl A. [1 ]
Stähelin H.B. [2 ]
Tichelli A. [3 ]
机构：
[1] Division of Hematology, Basel University Hospital, Basel
[2] Geriatric University Clinic, Department of Internal Medicine, Basel University Hospital, Basel
[3] Dept. Zentrallaboratorium, Kantonsspital Basel, 4031 Basel
来源：
Annals of Hematology | 2001年 / 80卷 / 5期
关键词：
Age; Anemia; Anemia of chronic disease; Geriatric; Iron deficiency; Malnutrition;
D O I：
10.1007/s002770100287
中图分类号：
学科分类号：
摘要：
The prevalence of anemia increases with age and is frequently multifactorial. We postulated that malnutrition contributes to anemia in the elderly and is underdiagnosed. Our objective was to analyze the prevalence of anemia and its association with nutritional status in a hospitalized geriatric population. Included in this retrospective cohort study were 186 consecutive patients admitted in 1997 to a geriatric unit of a university hospital. We compared hematological and chemical blood tests routinely performed upon admission in patients with anemia (hemoglobin <120 g/l) and without anemia (hemoglobin ≥120 g/l). Using these admission parameters, we defined a multiparameter score of malnutrition by low lymphocyte counts, decreased values of albumin, cholesterol, transferrin, cholinesterase, and zinc, iron deficiency by low transferrin saturation and normal C-reactive protein, and inflammation by increased C-reactive protein and high transferrin saturation. Of the 186 patients, 82 (44%) met the criteria for anemia on admission. In univariate analysis, patients with anemia differed significantly from patients with normal hemoglobin exhibiting lower serum values of albumin, iron, transferrin, cholesterol, cholinesterase, zinc, transferrin saturation, and lymphocyte count and higher C-reactive protein levels. Using a multiparameter score, anemia correlated significantly with parameters of malnutrition (P=0.0001) but not with iron deficiency (P=0.5) or with inflammation (P=0.08). In a multivariate logistic regression model, anemia was significantly associated with serum albumin (RR: 1.138; 95% CI: 1.056-1.227; P=0.0007), cholinesterase (RR: 1.387; 95% CI 1.122-1.714; P=0.0025), and transferrin saturation (RR: 1.05; 95% CI: 1.012-1.09; P=0.009). We conclude that malnutrition may play an important etiologic role in anemia in the elderly.
引用
收藏
页码：295 / 298
页数：3
相关论文
共 14 条
  • [1] Ania B.J., Suman V.J., Fairbanks V.F., Rademacher D.M., Melton L.J., Incidence of anemia in older people: An epidemiologic study in a well defined population, J Am Geriatr Soc, 45, pp. 825-831, (1997)
  • [2] Beard C.M., Kokmen E., O'Brien P.C., Ania B.J., Melton L.J., Risk of Alzheimer's disease among elderly patients with anemia: Population-based investigations in Olmsted County, Minnesota, Ann Epidemiol, 7, pp. 219-243, (1997)
  • [3] Bopp-Kistler I., Ruegger-Frey B., Grob D., Six P., Vitamin B<sub>12</sub> deficiency in geriatrics, Schweiz Rundsch Med Prax, 88, pp. 1867-1875, (1999)
  • [4] Chiari M.M., Bagnoli R., Luca P.D., Influence of acute inflammation on iron and nutritional status indexes in older in-patients, J Am Geriatr Soc, 43, pp. 767-771, (1995)
  • [5] Daly M.P., Sobal J., Anemia in the elderly: A survey of physicians' approaches to diagnosis and workup, J Fam Pract, 5, pp. 524-528, (1989)
  • [6] Guyatt G.H., Patterson C., Ali M., Singer J., Levine M., Turpie I., Meyer R., Diagnosis of iron-deficiency anemia in the elderly, Am J Med, 88, pp. 205-209, (1990)
  • [7] Inelmen E.M., D'Alessio M., Gatto M.R., Baggio M.B., Jimenez G., Bizzotto M.G., Enzi G., Descriptive analysis of the prevalence of anemia in a randomly selected sample of elderly people living at home: Some results of an Italian multicentric study, Aging, 6, pp. 81-89, (1994)
  • [8] Izaks G.J., Westerndorp R.G.J., Knook D.L., The definition of anemia in older persons, JAMA, 281, pp. 1714-1717, (1999)
  • [9] Joosten E., Pelemans W., Hiele M., Noyen J., Verhaeghe R., Boogaerts M.A., Prevalence and causes of anaemia in a geriatric hospitalized population, Gerontology, 38, pp. 111-117, (1992)
  • [10] Kis A.M., Carnes M., Detecting iron deficiency in anemic patients with concomitant medical problems, J Gen Intern Med, 13, pp. 455-461, (1998)
12