The pale evidence for treatment of iron-deficiency anaemia in older people

Soiza, Roy L.; Donaldson, Alison; Myint, Phyo Kyaw

doi:10.1177/2042098618769568

Cited by 35 publications

(15 citation statements)

References 17 publications

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“…Anemia, in which iron deficiency is one of the major causes, is a well-known risk factor for impaired activities of daily living (ADL) in older persons [ 10 ]. Indeed, it is associated with a decline in functional capacity, fatigue, a higher rate of hospitalization, impaired cognitive function, depression, and increased risk of falling and mortality [ 10 – 12 ]. Findings of an observational study among 579 older hospitalized patients aged ≥70 years demonstrated a significant lower ADL, as measured by Barthel Index (BI), in anemic patients [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Noteworthy, anemia in geriatric patients is usually a consequence of multimorbidity and rarely caused by one single reason [ 13 ]. However, poor nutritional intake of iron [ 3 ] and diseases accompanied by inflammation followed by reduced iron absorption and availability are risk factors associated with systemic iron depletion [ 3 , 14 ], due to increased inflammatory hepcidin expression, a regulator of intestinal iron absorption and metabolic iron availability [ 12 ]. Iron acts as an oxygen-binding element and is therefore crucial for oxygen supply of the organism [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Iron deficiency, fatigue and muscle strength and function in older hospitalized patients

2020

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Background/Objectives Iron deficiency is common in older patients. We investigated whether iron deficiency is an independent risk factor for functional impairment, low muscle function, fatigue, and rehabilitation progress in older hospitalized patients. Subjects/Methods Two hundred twenty-four patients (age range 65–95 years; 67% females) who were consecutively admitted to a geriatric acute care ward participated in this prospective longitudinal observational study. Ferritin, iron, transferrin in serum, and blood hemoglobin were measured and current iron supplementation was recorded. Fatigue and comorbidity were measured using the fatigue severity scale and Charlson Comorbidity Index, respectively. Barthel Index, handgrip strength, and isometric knee extension strength were conducted at the time of hospital admission and before discharge. Results Ninety-one (41%) patients had iron deficiency in which the majority had functional iron deficiency (78/91, 86%). Absolute iron deficiency with and without anemia was diagnosed in 12 (13%) and one patients, respectively. Barthel Index and handgrip and knee extension strength significantly improved during hospitalization in iron deficiency and non-iron deficiency groups. Knee extension strength showed better improvement in iron-deficient patients receiving iron supplementation and iron supplementation during hospital stay was the main predictor for improvement in knee extension strength. Comorbidity, iron deficiency, and changes in handgrip strength were the major independent risk factors for poor improvement in Barthel Index during hospitalization. There were significant associations between patients’ fatigue and iron deficiency, comorbidity, and female gender. Conclusion Iron deficiency is an independent risk factor for fatigue and poor functional recovery among older hospitalized patients. Iron supplementation seems to be capable of improving functional performance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Iron deficiency, fatigue and muscle strength and function in older hospitalized patients

2020

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“…Important gaps in the existing literature include evidence for the optimal dosing regimen for oral iron, clarification of the best strategy for those not responding to oral iron, and establishing whether oral or IV iron therapy improves physical function and quality of life compared with no therapy in older patients with non-severe iron deficiency anaemia. 11 Although there is evidence of benefit of IV iron in numerous clinical conditions, trials have recruited mostly younger patients. Arguably, improved quality of life in elders has been found only in the context of heart failure in the FAIR-HF trial, which recruited mostly patients in late middle-age.…”

Section: Discussionmentioning

confidence: 99%

Variability in the clinical management of iron deficiency anaemia in older adults: results from a survey of UK specialists in the care of older people

Donaldson

Soiza

Hands

et al. 2019

Therapeutic Advances in Drug Safety

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Background: Iron deficiency anaemia in older adults is common, but its management presents unique challenges in diagnosis and management. Little is known about compliance with current best practice guidelines. Methods: We undertook an online survey of physician members of the British Geriatrics Society to ascertain how they managed older patients with potential iron deficiency anaemia. Results: There were 141 respondents (96% from UK). Almost a third indicated they would accept haemoglobin levels <100 g/dl without further investigation. A quarter said they would only occasionally or never check ferritin levels. Only 30% would sometimes or always use parenteral iron when oral supplements were not tolerated. Conclusions: Responses suggest a high level of variation in clinical practice and low adherence to best practice guidelines. Possible explanations include an inadequate evidence base to guide management and a lack of knowledge on the challenges of managing iron deficiency anaemia in this population.

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“…Dados revelam que o tamanho e a forma das AgNPs influenciam diretamente a atividade antiviral (Pilaquinga et al, 2021).Partículas menores, com tamanho menor que 10 nm, possuem superfícies maiores e mais reativas e formatos como o triangular, barra ou espiral afetam drasticamente suas ações virais, enquanto partículas esféricas e cilíndricas seriam mais facilmente fagocitadas pelas células de defesa (Marimuthu et al, 2020;Soiza et al, 2018). No entanto, AgNPs esféricas têem se mostrado eficaz na redução da carga viral do agente causador.…”

Section: Aplicações Das Agnp Em Fibras Têxteis E Sua Atividade Antimi...unclassified

O uso de fibras têxteis impregnadas com nanopartículas de prata para enfretamento de doenças infeciosas, seus riscos à saúde e a sua regulação sanitária

Pereira

Santos

Barata-Silva

et al. 2022

RSD

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Introdução: O surgimento da pandemia causada pelo novo Coronavírus, tem se tornado um dos grandes desafios do século XXI. O uso da nanotecnologia em fibras têxteis tem potencial para se tornar um recurso para o enfretamento da pandemia. Nesse campo, merecem destaque os tecidos impregnados com nanopartículas de prata (AgNP), graças a seus atributos antivirais e anrtibacterianos. Objetivos: Essa revisão integrativa visou avaliar suas aplicações, eficácia antimicrobiana, riscos e regulação de forma a contribuir ao combate a pandemia de COVID-19, assim como de outras doenças infeciosas. Metodologia: Para a realização desse estudo foram realizadas buscas na literatura. Resultados e Discussão: Os resultados demonstraram que as AgNPs impregnadas em tecidos podem ter uma ampla aplicação no campo médico. A literatura apontou também uma relevante capacidade antimicrobiana das AgNPs, contudo essa capacidade parece ter relação com seu diâmetro e forma. Grande parte dos nanomateriais são classificados como GRAS, entretanto essa classificação foi feita pela extrapolação dos dados obtidos em formas não nanométricas. De maneira geral as informações sobre a biodisponibilidade e toxicocinética de nanomateriais são pouco conhecidas. Em termos regulatórios, apesar de avanços recentes, trata-se de um tema ainda em discussão. Conclusões: Apesar de ainda existirem muitas lacunas regulatórias no tema, o uso das AgNP, não somente em fibras têxteis, pode se tornar um recurso valioso, não somente para o enfrentamento da pandemia de COVD-19, mas como de outras doenças causadas por microrganismos.

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The pale evidence for treatment of iron-deficiency anaemia in older people

Cited by 35 publications

References 17 publications

Iron deficiency, fatigue and muscle strength and function in older hospitalized patients

Iron deficiency, fatigue and muscle strength and function in older hospitalized patients

Variability in the clinical management of iron deficiency anaemia in older adults: results from a survey of UK specialists in the care of older people

O uso de fibras têxteis impregnadas com nanopartículas de prata para enfretamento de doenças infeciosas, seus riscos à saúde e a sua regulação sanitária

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