Woodman Richard, Ferrucci Luigi, Guralnik Jack
Ortho Biotech Clinical Affairs, Bridgewater, NJ 08807, USA.
Curr Opin Hematol. 2005 Mar;12(2):123-8. doi: 10.1097/01.moh.0000154030.13020.85.
Anemia is common in older adults and is an independent predictor for increased morbidity and mortality in several disease states. Older persons with anemia suffer hospitalization, physical decline, and disability at higher rates than those people without anemia.
The prevalence and causes of anemia in community-dwelling older persons in the US were evaluated in the third National Health and Nutrition Examination Survey (NHANES) 1988-1994. In persons 65 years and older, anemia was present in 11.0% of men and 10.2% of women, with the prevalence rising to over 20% in people 85 years and older. One third of the cases were due to nutritional deficiencies, and one third was due to chronic illness, including but not limited to chronic kidney disease. About one third of the cases of anemia remain unexplained. Anemia is also prognostic for diminished physical performance and loss of mobility in people 65 years and older. A recent report suggests that the prevalence of anemia is even higher in elderly persons living in nursing homes. The data suggest that the risk of mortality and loss of mobility even extends to levels of hemoglobin normally considered low normal by WHO criteria, raising the question about optimal hemoglobin levels in the elderly.
Anemia is a common modifiable predictor of poor medical outcome in older adults and, as such, should be actively managed. Clinical studies are necessary to assess the effect of treatment of anemia on outcomes specific to the elderly, like disability.
贫血在老年人中很常见，并且是多种疾病状态下发病率和死亡率增加的独立预测因素。贫血的老年人比无贫血的人住院率更高，身体机能下降更快，残疾风险也更高。
在美国第三次国家健康和营养检查调查（NHANES，1988 - 1994年）中，对社区居住的老年人贫血的患病率及病因进行了评估。在65岁及以上人群中，男性贫血患病率为11.0%，女性为10.2%，85岁及以上人群的患病率升至20%以上。三分之一的病例归因于营养缺乏，三分之一归因于慢性疾病，包括但不限于慢性肾脏病。约三分之一的贫血病例病因不明。贫血也是65岁及以上人群身体机能下降和行动能力丧失的预后因素。最近一份报告表明，住在养老院的老年人贫血患病率更高。数据显示，死亡率和行动能力丧失的风险甚至延伸至世界卫生组织标准通常认为略低于正常水平的血红蛋白浓度，这引发了关于老年人最佳血红蛋白水平的问题。
贫血是老年人不良医疗结局的常见且可改变的预测因素，因此应积极进行管理。有必要开展临床研究，以评估贫血治疗对老年人特定结局（如残疾）的影响。
