Introduction

Anemia, whose prevalence and incidence increase with age, has been associated with a number of adverse outcomes in older individuals. It is attractive to hypothesize that the reversal of anemia may effect compression of morbidity, which is the main goal of geriatric medicine. More prolonged health and independence may improve the quality of life and reduce the management cost of the older aged person.

After studying the epidemiology of anemia and aging, this chapter explores the adverse consequences of anemia in the elderly and the outcomes of anemia management.

Epidemiology and causes of anemia in older age

Definition of anemia

The World Health Organization (WHO) defines anemia as hemoglobin levels lower than 12 g/dL in women and 13.5 g/dL in men. In older people, however, this definition should be revised based on two types of findings:

• People of different ethnic origins may have different levels of hemoglobin in homeostatic conditions. In the NHANES III study, the prevalence of anemia was much higher among older African-Americans than among white, Asian, or Hispanic elderly (Fig. 15.1). In the same database Patel et al. demonstrated that mild anemia was not associated with adverse outcomes in blacks. These findings suggest that hemoglobin levels may be lower in black individuals than in other ethnic groups in normal conditions.

• […]