Zuin Marco, Ferrucci Luigi, Zuliani Giovanni
Department of Translational Medicine, University of Ferrara - UNIFE, 44124, Ferrara, Italy.
Translational Gerontology Branch, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA.
Aging Clin Exp Res. 2025 Mar 22;37(1):99. doi: 10.1007/s40520-025-02982-0.
Previous investigations showed that the prevalence of iron deficiency is increasing in United States (US). However, data regarding iron deficiency anemia-related mortality trends are lacking. We assess the trends in iron deficiency anemia-related mortality in US adults aged 65 years or older over the last two decades.
Iron-deficiency anemia-related deaths were ascertained using ICD-10 codes in the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2019. Age-adjusted mortality rates (AAMRs) were assessed using the Joinpoint regression modelling and expressed as estimated average annual percentage change (AAPC) and annual percent change (APC) with relative 95% confidence interval (95% CI), stratified by level of urbanization, sex, age, and race.
Between 1999 and 2019, 30,540 US subjects aged ≥ 65 years old (11,986 men and 18,554 women) equating to 77.8 deaths per 100,000 or 27.9 deaths per week, had iron deficiency anemia listed as a cause of death. The AAMR remained stable from 1999 to 2013 [APC: -0.3, (95%CI: -0.9 to 0.1, p = 0.11)] and then sharply increased from 2013 to 2019 [APC: +9.7% (95%CI: 7.8 to 11.6), p < 0.0001) without differences in sex, race, ethnicity or level of urbanization. The higher AAMRs were clustered in the Midwest [4.29 per 100,000 (95% CI: 4.20 to 4.38)] and in the South [3.35 per 100,000, 95% CI: 3.28 to 3.35)].
Over the last two decades the iron deficiency anemia-related mortality trends increased among US older subjects, without differences by sex, race, ethnicity or urbanicity.
先前的调查显示，美国缺铁患病率呈上升趋势。然而，目前缺乏缺铁性贫血相关死亡率趋势的数据。我们评估了过去二十年美国65岁及以上成年人缺铁性贫血相关死亡率的趋势。
利用疾病控制与预防中心广泛在线流行病学研究数据（CDC WONDER）数据库中的ICD-10编码，确定1999年至2019年期间与缺铁性贫血相关的死亡病例。采用Joinpoint回归模型评估年龄调整死亡率（AAMR），并以估计平均年百分比变化（AAPC）和年百分比变化（APC）表示，同时给出相对95%置信区间（95%CI），按城市化水平、性别、年龄和种族进行分层。
1999年至2019年期间，30540名年龄≥65岁的美国受试者（11986名男性和18554名女性），每10万人中有77.8人死亡，即每周有27.9人死亡，其死亡原因被列为缺铁性贫血。1999年至2013年，AAMR保持稳定[APC：-0.3，（95%CI：-0.9至0.1，p = 0.11）]，随后在2013年至2019年急剧上升[APC：+9.7%（95%CI：7.8至11.6），p < 0.0001]，性别、种族、民族或城市化水平方面无差异。较高的AAMR集中在中西部地区[每10万人中有4.29人（95%CI：4.20至4.38）]和南部地区[每10万人中有3.35人，95%CI：3.28至3.35]。
在过去二十年中，美国老年人群中与缺铁性贫血相关的死亡率呈上升趋势，在性别、种族、民族或城市化程度方面无差异。
