Department of Geriatrics, Catholic University of Rome and IRCCS Fondazione Policlinico "A. Gemelli", Rome, Italy.
Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Aging Clin Exp Res. 2020 Nov;32(11):2211-2216. doi: 10.1007/s40520-019-01454-6. Epub 2020 Jan 1.
Iron deficiency is a major cause of anemia in older people. Increasing the knowledge on the predictors of iron-deficiency anemia (IDA) may facilitate its timely diagnosis.
To investigate the predictors of IDA in older people in four European countries.
Retrospective longitudinal study. Primary care patients aged 65 or older (N = 24,051) in four European countries.
IDA predictors were estimated using multivariate Cox regression based on information gathered from national primary care databases: Italy (years 2002-2013), Belgium, Germany and Spain (years 2007-2012). Adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) were estimated.
In Spain and Belgium, men were at greater risk of IDA than women, while they had a lower risk in Italy. Weakness, irritability, alopecia and xerostomia were signs and symptoms significantly associated with IDA. Concurrent diseases, potential causes of anemia, positively associated with IDA were small bowel polyposis, stomach cancer, obesity, gastritis and peptic ulcer, esophagitis, Crohn's disease, celiac disease, lymphangiectasis, gastrectomy or gastric atrophy, gut resection or bypass, and cardiac prosthetic valve. Aspirin users had a 12-35% higher hazard of IDA than non-users. Similarly, corticosteroids and anti-acids were positively associated with IDA. A higher level of comorbidity was associated with an increased hazard of IDA in all countries.
Specific signs and symptoms, chronic conditions, a greater comorbidity burden, and specific pharmacological treatments registered in primary care databases represent relevant predictors and correlates of incident IDA in older people in Europe. General practitioners might employ this information to obtain early diagnosis of IDA in community-dwelling older adults.
缺铁是老年人贫血的主要原因。增加对缺铁性贫血（IDA）预测因素的了解，可能有助于及时诊断。
调查欧洲四个国家老年人 IDA 的预测因素。
回顾性纵向研究。来自欧洲四个国家初级保健患者（年龄≥65 岁）（N=24051）。
使用基于国家初级保健数据库收集的信息，采用多变量 Cox 回归估计 IDA 的预测因素：意大利（2002-2013 年）、比利时、德国和西班牙（2007-2012 年）。估计调整后的危险比（aHR）及其 95%置信区间（CI）。
在西班牙和比利时，男性患 IDA 的风险高于女性，而在意大利，男性患 IDA 的风险较低。虚弱、易怒、脱发和口干是与 IDA 显著相关的体征和症状。小肠息肉、胃癌、肥胖、胃炎和消化性溃疡、食管炎、克罗恩病、乳糜泻、淋巴管扩张、胃切除术或胃萎缩、肠道切除术或旁路术以及心脏人工瓣膜等潜在贫血原因的共存疾病与 IDA 呈正相关。与非使用者相比，阿司匹林使用者发生 IDA 的危险增加 12-35%。同样，皮质类固醇和抗酸剂与 IDA 呈正相关。在所有国家，较高的共病水平与 IDA 的发生危险增加相关。
初级保健数据库中登记的特定体征和症状、慢性疾病、更高的共病负担和特定的药物治疗是欧洲老年人新发 IDA 的重要预测因素和相关因素。全科医生可以利用这些信息，尽早诊断社区居住的老年人 IDA。
