New horizons in iron deficiency anaemia in older adults

Abstract

Iron deficiency anaemia (IDA) is common in older adults and associated with a range of adverse outcomes. Differentiating iron deficiency from other causes of anaemia is important to ensure appropriate investigations and treatment. It is possible to make the diagnosis reliably using simple blood tests. Clinical evaluation and assessment are required to help determine the underlying cause and to initiate appropriate investigations. IDA in men and post-menopausal females is most commonly due to occult gastrointestinal blood loss until proven otherwise, although there is a spectrum of underlying causative pathologies. Investigation decisions should take account of the wishes of the patient and their competing comorbidities, individualising the approach. Management involves supplementation using oral or intravenous (IV) iron then consideration of treatment of the underlying cause of deficiency. Future research areas are outlined including the role of Hepcidin and serum soluble transferrin receptor measurement, quantitative faecal immunochemical testing, alternative dosing regimens and the potential role of IV iron preparations.

Refinement and validation of the IDIOM score for predicting the risk of gastrointestinal cancer in iron deficiency anaemia

“…IDA is a particular challenge in the elderly, 24 as this is the age group with the highest prevalence of IDA, and the highest risk of underlying GI cancer. 2 However, it is also the age group at highest risk of complications from invasive investigation or from subsequent surgery if required-and debatably the least to gain from intervention.…”

Iron Deficiency: Impact on Functional Capacity and Quality of Life in Heart Failure with Preserved Ejection Fraction

“…TSAT was associated with worse functional capacity, while sTfR showed the highest performance as a predictor of functional capacity and also quality of life. sTfR is a biomarker that provides information on tissue iron demand and because it is insensitive to inflammation, it can detect anemia in patients with preexisting inflammatory states, which is particularly useful in distinguishing between anemia of chronic disease and anemias caused by lack of iron intake [33][34][35]. Previous studies of our group had already shown its ability to predict effort capacity and quality of life in patients with chronic HF globally [18], and this paper studies its impact and predictive value specifically in HFpEF compared with other iron metabolism biomarkers and explores differences along the HFpEF LVEF range.…”

Iron deficiency is not the main contributor to anemia in older Mexican adults: results from the National Health and Nutrition Survey 2018-19

“…37 Others consider alternative iron indicators, such as serum transferrin receptor. 38 Nonetheless, no consensus has been reached to allow a standardized diagnosis of ID in OA. According to WHO cutoff thresholds, ID prevalence in older Mexican adults is low and may be underestimated when compared to the magnitude of anemia reported in this population.…”