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Background: Increased mortality in patients with anemia has been demonstrated in disabled, seriously ill or hospitalized patients. In industrialized nations with their aging societies, however, elderly but apparently healthy family-physician patients are an important demographic group from a public-health perspective. We therefore set out to evaluate the prevalence of anemia in this group and associations between anemia and 5-year all-cause mortality, adjusted for multiple other established risk factors and chronic diseases.
Methods: This was a monitored, prospective cohort study in Germany with 344 representative family physicians who documented, consecutively, elderly patients (aged >or= 65 years). Extensive fasting plasma parameters were collected at baseline. Anemia at inclusion was defined according to World Health Organization criteria (hemoglobin below 12 g/dl in women and 13 g/dl in men). All participants were followed up for death of any cause for 5.3 years.
Results: Among the 6880 individuals, 2905 men and 3975 women, aged 65-95 (mean age 72.5), mild anemia (hemoglobin levels >or=10 g/dl) was found in 6.1% of women and 8.1% of men. Among those patients, 36.1% of anemic men and 15.0% of anemic women died. In a Cox proportional hazards analysis, multiple adjusted for potential confounders including major comorbidities, a near doubling of the 5-year mortality risk in anemic men (hazard ratio [HR] 1.9; 95% confidence interval [CI] 1.5-2.4) was found, while in anemic women there was no risk increase at all (HR 1.1; 95% CI 0.8-1.6). Even if patients with the lowest hemoglobin concentration (<11 g/dl for women, <12 g/dl for men) are singled out for multiple-adjusted analysis, anemia in men was related to a significant mortality risk (HR 3.3; 95% CI 2.1-5.1), but not in women (HR 1.85; 95% CI 0.97-3.53).
Conclusion: In typical elderly patients without severe comorbidities, mild anemia was significantly associated with greater mortality in men but not in women. Given the impact of sex on outcomes of older subjects with mild anemia, the current definition of anemia should be adjusted for elderly males towards a higher hemoglobin threshold. Interventional trials will be needed to determine whether a consistent correction of anemia improves mortality of older men.
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http://dx.doi.org/10.1185/03007990902860325 | DOI Listing |
Intern Med J
December 2024
Internal Medicine Services, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Background: Iron deficiency anaemia (IDA) related to occult gastrointestinal tract (GIT) blood loss is associated with high rates of GIT malignancies. Major society guidelines recommend bidirectional endoscopic evaluation for all men and post-menopausal women with newly diagnosed, unexplained IDA. However, in patients prescribed direct oral anticoagulants (DOACs), the endoscopic yield, specifically the rate of high-risk findings, including colorectal cancers (CRCs) and advanced adenomas (AAs), is unknown.
View Article and Find Full Text PDFBlood Res
December 2024
Division of Hematology-Oncology, Hanyang University Seoul Hospital, Seoul, Republic of Korea.
Purpose: This study investigated the occurrence of subsequent malignancies (SM) in adult patients with severe aplastic anemia (SAA) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) to address the lack of large-scale, long-term data on this complication.
Methods: A retrospective cohort analysis of 376 adult patients with SAA who underwent allo-HSCT between 2002 and 2021 at a single center was conducted. The incidence, risk factors, and survival impact of SM were also examined.
Lancet Infect Dis
December 2024
Training and Research Unit of Excellence, Blantyre, Malawi; School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Background: In many sub-Saharan African countries, it is recommended that children with sickle cell anaemia receive malaria chemoprevention with monthly sulfadoxine-pyrimethamine or daily proguanil as the standard of care. However, the efficacy of these interventions is compromised by high-grade antifolate resistance of Plasmodium falciparum and poor adherence. We aimed to compare the efficacy of weekly dihydroartemisinin-piperaquine and monthly sulfadoxine-pyrimethamine for the prevention of clinical malaria in children with sickle cell anaemia in areas with high-grade sulfadoxine-pyrimethamine resistance of P falciparum in Uganda and Malawi.
View Article and Find Full Text PDFAsia Pac J Public Health
December 2024
Department of Science and Technology, Food and Nutrition Research Institute, DOST Compound, Taguig City, Metro Manila, Philippines.
In the Philippines, the co-occurrence of two or more types of malnutrition in an individual, also known as intra-individual double burden of malnutrition (DBM), has rarely been investigated. This study aimed to determine the prevalence of and the factors associated with DBM at the individual level among Filipino women of reproductive age (WRA) using the data collected from the 2018 Philippine Expanded National Nutrition Survey. For this study, intra-individual DBM was defined as the co-existence of overweight or obesity and anemia in an individual.
View Article and Find Full Text PDFCurr Dev Nutr
December 2024
NutritionWorks, Bristol, United Kingdom.
Anemia is a global public health and nutrition problem. However, data on its prevalence and potential causal factors in the 22 countries of the UNICEF Europe and Central Asia region are not systematically collected, analyzed, and reported, leading to challenges in formulating appropriate preventative strategies. We examined available anemia prevalence data among different population groups through reviewing survey reports from 2010 to 2022; conducted a literature review to explore underlying determinants of anemia including iron deficiency; and collated and reviewed program and policy documentation across the region.
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