High Anemia Prevalence in Korean Older Adults, an Advent Healthcare Problem: 2007-2016 KNHANES

Abstract

BACKGROUND: Anemia is associated with high morbidity and mortality in older people. However, anemia in older individuals is not fully understood, and national data on the prevalence and characteristics of anemia in Korean older people are lacking. This study aimed to evaluate the prevalence and characteristics of anemia in older adults using data from the Korea National Health and Nutrition Examination Survey (KNHANES), which is the nation-wide cross-sectional epidemiological study conducted by Korean Ministry of Health and Welfare.Methods: Data from the total of 62,825 participants of the 2007-2016 KNHANES were merged and analyzed to investigate differences in participant characteristics and potential risk factors for anemia. Differences in participant characteristics were compared across subgroups using the chi-squared test for categorical variables and independent t-test for continuous variables. Univariate and multivariate analyses using logistic regression were performed to identify related clinical factors.RESULTS: The prevalence of anemia was higher in the population aged ≥65 years than in the younger population. Anemia was also more prevalent among females than among males, but the difference was not statistically significant in people aged >85 years. Being underweight, receiving a social allowance, living alone, and having comorbidities such as hypertension, rheumatoid arthritis, diabetes mellitus (DM), cancer, and chronic renal failure (CRF) were more prevalent in older adults with anemia than in the group without anemia. In the univariate and multivariate analyses, older age, female sex, underweight, and comorbidities including rheumatoid arthritis, DM, cancer, and CRF were associated with an increased risk of anemia. CONCLUSIONS: This study revealed that age, female sex, underweight, and the presence of comorbidities such as rheumatoid arthritis, DM, cancer, and CRF were associated with an increased risk of anemia in Korean older adults. Further study on causal relationships between anemia and other variables in the older population is necessary.

Erythropoiesis changes with increasing age in the elderly Chinese

“…It is a physiological finding that the prevalence of asymptomatic and mild anaemia increases in apparently healthy elderly, which is also confirmed by other studies, 12‐14 suggesting that the decrease in haemoglobin levels might be a consequence of the normal ageing process. Similarly, Phillips et al show nutritional deficiency and age‐associated renal dysfunction are not the main reason for age‐related trends 15 .…”

“…Although haemocyte RI studies in Chinese children as well as in some regions of China have been reported 10,11 the trends of RBC parameters in these studies represented the characteristics of a certain area, young children or adults, not covered aged population nationwide. In this study, 6.47% of people aged ≥ 60 y have anaemia, which is lower than 14.0% in South Korea and 10.6% in the United States, 12 the prevalence of anaemia remains high. For better clinical decisions, such as transfusion or medical treatment for anaemia in the elderly, a specific reference interval for ageing people is required.…”