nach oben

Zeitschrift für Gerontologie und Geriatrie

Erschienen in:

29.11.2018 | CME

Anämie im Alter

verfasst von: PD Dr. Gabriele Röhrig, MPH

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Eine Anämie bei älteren Patienten stellt ein bis heute oft unterschätztes klinisches Problem dar. Allerdings konnten in den letzten Jahren durch zunehmende wissenschaftliche Auseinandersetzung mit dem Thema wichtige Einsichten gewonnen werden, die eine sehr differenzierte Einschätzung der Anämie beim älteren Patienten erlauben. So sind inzwischen sowohl die Multikausalität als auch komplexe negative Auswirkungen anerkannte Charakteristika der Anämie beim älteren Menschen, was zu der Diskussion geführt hat, die Anämie im Alter als geriatrisches Syndrom zu werten. Der vorliegende Beitrag gibt eine aktualisierte Übersicht über den Stand der Wissenschaft hinsichtlich dieses klinisch hoch relevanten Themas.

Vorheriger Artikel Komplikationen durch verblisterte Medikamente und ihre Vermeidung

Nächster Artikel Journal Club

Andro M, Le Squere P, Estivin S, Gentric A (2013) Anaemia and cognitive performances in the elderly: a systematic review. Eur J Neurol 20(9):1234–1240CrossRefPubMed

Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, Cushman MA (2005) A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med 165(19):2214–2220CrossRefPubMed

McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B (2009) Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr 12(4):444–454CrossRefPubMed

Bach V, Schruckmayer G, Sam I, Kemmler G, Stauder R (2014) Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Clin Interv Aging 9:1187–1196. https://doi.org/10.2147/CIA.S61125 CrossRefPubMedPubMedCentral

Gaskell H, Derry S, Moore AR, McQuay HJ (2008) Prevalence of anaemia in older persons: systematic review. Bmc Geriatr 8:1. https://doi.org/10.1186/1471-2318-8-1 CrossRefPubMedPubMedCentral

Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC (2004) Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 104(8):2263–2268CrossRef

Röhrig G, Klossok W, Becker I, Benzing T, Schulz RJ (2014) Prevalence of anemia among elderly patients in an emergency room setting. Eur Geriatr Med 5(1):3–7CrossRef

Zilinski J, Zillmann R, Becker I, Benzing T, Schulz RJ, Roehrig G (2014) Prevalence of anemia among elderly inpatients and its association with multidimensional loss of function. Ann Hematol 93(10):1645–1654CrossRefPubMed

Röhrig G, Hörter M, Becker I, Adams A, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016a) Anemia and hematologic parameters in older patients: results of a German multicentric cross-sectional study. Eur Geriatr Med 7(4):328–332CrossRef

10.

Eisele L, Dürig J, Broecker-Preuss M, Dührsen U, Bokhof B, Erbel R, Moebus S, Jöckel KH, Heinz Nixdorf Recall Study Investigative Group (2013) Prevalence and incidence of anemia in the German Heinz Nixdorf Recall Study. Ann Hematol 92(6):731–737. https://doi.org/10.1007/s00277-013-1697-1 CrossRefPubMed

11.

Röhrig G, Gütgemann I, Gutensohn K, Nebe T (2017) Red blood cell counts and indices in the elderly German population. J Lab Med. https://doi.org/10.1515/labmed-2017-0080 CrossRef

12.

Beutler E, Waalen J (2006) The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 107(5):1747–1750CrossRefPubMedPubMedCentral

13.

Owusu C, Cohen HJ, Feng T, Tew W, Mohile SG, Klepin HD, Gross CP, Gajra A, Lichtman SM, Hurria A, Cancer and Aging Research Group [CARG] (2015) Anemia and functional disability in older adults with cancer. J Natl Compr Canc Netw 13(10):1233–1239CrossRefPubMedPubMedCentral

14.

World Health Organization (1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37

15.

Hagemann O (2004) Laboratory lexicon. ISSN 1860-966X. http://www.laboratory-lexicon.com/Lexikon/Infoframe/f/Ferritin.htm. Zugegriffen: 29. Juli 2016

16.

Thomas L (2005) Labor und Diagnose, 6. Aufl. TH-Books, Frankfurt a.M.

17.

Wish JB (2006) Assessing iron status: beyond serum ferritin and transferrin saturation. Clin J Am Soc Nephrol 1(Suppl 1):S4–S8CrossRefPubMed

18.

Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR (2006) Impact of anemia on hospitalization and mortality in older adults. Blood 107(10):3841–3846CrossRefPubMed

19.

Ambayya A, Su AT, Osman NH, Nik-Samsudin NR, Khalid K, Chang KM et al (2014) Haematological reference intervals in a multiethnic population. PLoS ONE 9:e91968CrossRefPubMedPubMedCentral

20.

Patel KV, Semba RD, Ferrucci L, Newman AB, Fried LP, Wallace RB, Bandinelli S, Phillips CS, Yu B, Connelly S, Shlipak MG, Chaves PH, Launer LJ, Ershler WB, Harris TB, Longo DL, Guralnik JM (2010) Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci 65(3):258–265. https://doi.org/10.1093/gerona/glp163 CrossRefPubMed

21.

Pérez-Martín A, Horrillo-Sánchez de Ocaña L, Satué-Bartolomé JA, Belinchón Paraíso JC, Gonzalo-Pascua S, Marrero-Francés J, Zapatero-Gaviria A (2014) Red cell distribution width and mortality following hospital discharge in patients over 70 years of age. Med Clin (Barc) 143(2):49–56. https://doi.org/10.1016/j.medcli.2013.05.027 CrossRef

22.

Lang E, Lang F (2015) Triggers, inhibitors, mechanisms, and significance of eryptosis: the suicidal erythrocyte death. Biomed Res Int 2015:513518. https://doi.org/10.1155/2015/513518 CrossRefPubMedPubMedCentral

23.

Lupescu A, Bissinger R, Goebel T, Salker MS, Alzoubi K, Liu G, Chirigiu L, Mack AF, Qadri SM, Lang F (2015) Enhanced suicidal erythrocyte death contributing to anemia in the elderly. Cell Physiol Biochem 36(2):773–783. https://doi.org/10.1159/000430137 CrossRefPubMed

24.

Cankurtaran M, Yavuz BB, Halil M, Ulger Z, Haznedaroğlu IC, Arıoğul C (2012) Increased ferritin levels could reflect ongoing aging-associated inflammation and may obscure underlying iron deficiency in the geriatric population. Eur Geriatr Med 3(5):277–280CrossRef

25.

Franceschi C, Campisi J (2014) Chronic inflammation [inflammaging] and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci 69(Suppl 1):S4–S9. https://doi.org/10.1093/gerona/glu057 CrossRefPubMed

26.

Metzgeroth G, Hastka J (2015) Iron deficiency anemia and anemia of chronic disorders. Internist (Berl) 56(9):978–988. https://doi.org/10.1007/s00108-015-3711-2 CrossRef

27.

Polepalle T, Moogala S, Boggarapu S, Pesala DS, Palagi FB (2015) Acute phase proteins and their role in periodontitis: a review. J Clin Diagn Res 9(11):ZE1–ZE5PubMedPubMedCentral

28.

Wirth R, Streicher M, Smoliner C, Kolb C, Hiesmayr M, Thiem U, Sieber CC, Volkert D (2015) The impact of weight loss and low BMI on mortality of nursing home residents - results from the nutritionDay in nursing homes. Clin Nutr. https://doi.org/10.1016/j.clnu.2015.06.003 CrossRefPubMed

29.

Fernández López MT, Fidalgo Baamil O, López Doldán C, Bardasco Alonso ML, de Sas Prada MT, Lagoa Labrador F, García García MJ, Mato Mato JA (2015) Prevalence of malnutrition in not critically ill older inpatients. Nutr Hosp 31(6):2676–2684. https://doi.org/10.3305/nh.2015.31.6.8989 CrossRefPubMed

30.

Maggio M, De Vita F, Fisichella A, Lauretani F, Ticinesi A, Ceresini G, Cappola A, Ferrucci L, Ceda GP (2015) The role of the multiple hormonal dysregulation in the onset of “anemia of aging”: focus on testosterone, IGF-1, and thyroid hormones. Int J Endocrinol 2015:292574. https://doi.org/10.1155/2015/292574 CrossRefPubMedPubMedCentral

31.

Maggio M, Lauretani F, Ceda GP, Bandinelli S, Ling SM, Metter EJ, Artoni A, Carassale L, Cazzato A, Ceresini G, Guralnik JM, Basaria S, Valenti G, Ferrucci L (2007) Relationship between low levels of anabolic hormones and 6‑year mortality in older men: the aging in the Chianti Area [InCHIANTI] study. Arch Intern Med 167(20):2249–2254CrossRefPubMedPubMedCentral

32.

Contreras M, Formiga F, Ferrer A, Chivite D, Padrós G, Montero A, Grupo Octabaix (2015) Profile and prognosis of patients over 85 years old with anemia living in the community. Octabaix Study. Rev Esp Geriatr Gerontol 50(5):211–215. https://doi.org/10.1016/j.regg.2014.11.004 CrossRef

33.

Martínez-Velilla N, Cambra-Contin K, García-Baztán A, Alonso-Renedo J, Herce PA, Ibáñez-Beroiz B (2015) Change in red blood cell distribution width during the last years of life in geriatric patients. J Nutr Health Aging 19(5):590–594. https://doi.org/10.1007/s12603-015-0470-7 CrossRefPubMed

34.

Röhrig G, Becker I, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016) Association between hematologic parameters and functional impairment among geriatric inpatients: data of a prospective cross-sectional multicenter study [“GeriPrävalenz2013”]. Maturitas 90:37–41CrossRefPubMed

35.

Romero-Ruperto S, Pérez-Bocanegra MC, Duran-Taberna M, Toscano-Rivera A, Barbé-Gil Ortega J, San José-Laporte A (2015) Anemia in elderly patients admitted to an acute geriatric ward. Rev Esp Geriatr Gerontol 50(3):122–125CrossRefPubMed

36.

Röhrig G, Becker I, Polidori MC, Schulz RJ, Noreik M (2015a) Association of anemia and hypoalbuminemia in German geriatric inpatients : relationship to nutritional status and comprehensive geriatric assessment. Z Gerontol Geriatr 48(7):619–624. https://doi.org/10.1007/s00391-015-0872-5 CrossRefPubMed

37.

Röhrig G, Rücker Y, Becker I, Schulz RJ, Lenzen-Großimlinghaus R, Willschrei P, Gebauer S, Modreker M, Jäger M, Wirth R (2017) Association of anemia with functional and nutritional status in the German multicenter study “GeriAnaemie2013”. Z Gerontol Geriatr 50(6):532–537CrossRefPubMed

38.

Hong CH, Falvey C, Harris TB, Simonsick EM, Satterfield S, Ferrucci L, Metti AL, Patel KV, Yaffe K (2013) Anemia and risk of dementia in older adults: findings from the Health ABC study. Neurology 81(6):528–533. https://doi.org/10.1212/WNL.0b013e31829e701d CrossRefPubMedPubMedCentral

39.

Zamboni V, Cesari M, Zuccalà G, Onder G, Woodman RC, Maraldi C, Ranzini M, Volpato S, Pahor M, Bernabei R (2006) Anemia and cognitive performance in hospitalized older patients: results from the GIFA study. Int J Geriatr Psychiatry 21(6):529–534CrossRefPubMed

40.

Umegaki H, Yanagawa M, Endo H (2011) Association of lower hemoglobin level with depressive mood in elderly women at high risk of requiring care. Geriatr Gerontol Int 11(3):262–266CrossRefPubMed

41.

Trevisan C et al (2016) Low hemoglobin levels and risk of developing depression in the elderly: results from the prospective PRO.V.A. Study. J Clin Psychiatry 77(12):e1549–e1556CrossRefPubMed

42.

Lieske B, Becker I, Schulz RJ, Polidori MC, Kassubek J, Röhrig G (2015) Intravenous iron administration in restless legs syndrome: an observational study in geriatric patients. Z Gerontol Geriatr. https://doi.org/10.1007/s00391-015-0984-y CrossRefPubMed

43.

Lieske B, Röhrig G, Becker I, Schulz RJ, Polidori MC, Kassubek J (2017) Stationär behandelte geriatrische Patienten mit Eisenmangel-assoziiertem Restless Legs Syndrom: eine retrospektive Analyse. MMW Fortschr Med. https://doi.org/10.1007/s15006-017-9294-1 CrossRefPubMed

44.

Röhrig G, Steinmetz T, Stein J, Geisel T, Virgin G, Schaefer R, Bach M, Schulz RJ (2014) Efficacy and tolerability of ferric carboxymaltose in geriatric patients with anemia. Data from three non-interventional studies. MMW Fortschr Med 156(Suppl 2):48–53CrossRefPubMed

45.

Röhrig G, Nobbe C, Weiß V, Schulz RJ (2013) Hepcidin in anaemic geriatric patients with non-dialysis chronic kidney disease (ND-CKD). Eur Geriatr Med 4(4):221–225CrossRef

46.

Zaritsky J, Young B, Wang HJ, Westerman M, Olbina G, Nemeth E et al (2009) Hepcidin — a potential novel biomarker for iron status in chronic kidney disease. Clin J Am Soc Nephrol 4:1051–1056CrossRefPubMedPubMedCentral

47.

Dahlerup JF, Eivindson M, Jacobsen BA, Jensen NM, Jørgensen SP, Laursen SB, Rasmussen M, Nathan T (2015) Diagnosis and treatment of unexplained anemia with iron deficiency without overt bleeding. Dan Med J 62(4):C5072PubMed

48.

Poetes J (1954) Oral iron therapy in hemorrhagic, infectious and tumorous anemias. Hippokrates 25(20):651–652PubMed

49.

Kulaksiz H, Theilig F, Bachmann S, Gehrke SG, Rost D, Janetzko A, Cetin Y, Stremmel W (2005) The iron-regulatory peptide hormone hepcidin: expression and cellular localization in the mammalian kidney. J Endocrinol 184(2):361–370CrossRefPubMed

50.

Nemeth E, Valore EV, Territo M, Schiller G, Lichtenstein A, Ganz T (2003) Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein. Blood 101(7):2461–2463CrossRefPubMed

51.

Gangat N, Wolanskyj AP (2013) Anemia of chronic disease. Semin Hematol 50(3):232–238. https://doi.org/10.1053/j.seminhematol.2013.06.006 CrossRefPubMed

52.

Bach M, Geisel T, Martin J, Schulze B, Schaefer R, Virgin G, Stein J (2015) Efficacy and safety of intravenous ferric carboxymaltose in geriatric inpatients at a German tertiary university teaching hospital: a retrospective observational cohort study of clinical practice. Anemia 2015:647930CrossRefPubMedPubMedCentral

53.

Reed J, Charytan C, Yee J (2007) The safety of intravenous iron sucrose use in the elderly patient. Consult Pharm 22(3):230–238CrossRefPubMed

54.

Tay HS, Soiza RL (2015) Systematic review and meta-analysis: what is the evidence for oral iron supplementation in treating anaemia in elderly people? Drugs Aging 32(2):149–158CrossRefPubMed

55.

Silay K, Akinci S, Yalcin A, Guney T, Ulas A, Ozer O, Ozbek S, Dilek I (2015) The status of iron absorption in older patients with iron deficiency anemia. Eur Rev Med Pharmacol Sci 19(17):3142–3145PubMed

56.

Hastka J, Heimpel H, Metzgeroth G (2011) Eisenmangel und Eisenmangelanämie: Onkopedia Leitlinie. https://www.onkopedia.com/de/onkopedia/guidelines/eisenmangel-und-eisenmangelanaemie. Zugegriffen: 29. Juli 2018

57.

Aapro MS et al (2006) Epoetin alfa increases hemoglobin levels and improves quality of life in anemic geriatric cancer patients receiving chemotherapy. Support Care Cancer 14(12):1184–1194CrossRefPubMed

58.

Io H et al (2015) Impact of anaemia treatment for left ventricular remodelling prior to initiation of dialysis in chronic kidney disease patients: efficacy and stability of long acting erythropoietin stimulating agents. Nephrology (Carlton). https://doi.org/10.1111/nep.12640 CrossRef

59.

Bundesärztekammer (2014) Kapitel 1. In: Leitlinien der Bundesärztekammer zur Therapie mit Blutkomponenten und Plasma Derivaten, 4. Aufl. Deutscher Ärzteverlag, Köln, S 10–19

60.

Gregersen M, Borris LC, Damsgaard EM (2015) Blood transfusion and overall quality of life after hip fracture in frail elderly patients-the transfusion requirements in frail elderly randomized controlled trial. J Am Med Dir Assoc 16(9):762–766. https://doi.org/10.1016/j.jamda.2015.03.022 CrossRefPubMed

61.

Carson JL, Sieber F, Cook DR, Hoover DR, Noveck H, Chaitman BR, Fleisher L, Beaupre L, Macaulay W, Rhoads GG, Paris B, Zagorin A, Sanders DW, Zakriya KJ, Magaziner J (2015) Liberal versus restrictive blood transfusion strategy: 3‑year survival and cause of death results from the FOCUS randomised controlled trial. Lancet 385(9974):1183–1189. https://doi.org/10.1016/S0140-6736(14)62286-8 CrossRef

Titel: Anämie im Alter
verfasst von: PD Dr. Gabriele Röhrig, MPH
Publikationsdatum: 29.11.2018
Verlag: Springer Medizin
Erschienen in: Zeitschrift für Gerontologie und Geriatrie / Ausgabe 8/2018
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI: https://doi.org/10.1007/s00391-018-01479-y

Schmerz im Alter

Themenschwerpunkt

Komplikationen durch verblisterte Medikamente und ihre Vermeidung

Kasuistiken

Gender differences in mortality among statin users aged 80 years or more

Original contribution

Schmerz und Alter

Editorial

Nichtmedikamentöse Schmerztherapie bei chronischem Schmerz

Themenschwerpunkt

Combined treatment with alendronate and Drynaria rhizome extracts

Original contribution

Springerpflege

Anämie im Alter

Zusammenfassung

Weitere Artikel der Ausgabe 8/2018

Schmerz im Alter

Komplikationen durch verblisterte Medikamente und ihre Vermeidung

Gender differences in mortality among statin users aged 80 years or more

Schmerz und Alter

Nichtmedikamentöse Schmerztherapie bei chronischem Schmerz

Combined treatment with alendronate and Drynaria rhizome extracts

Springerpflege

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Schmerz im Alter

Komplikationen durch verblisterte Medikamente und ihre Vermeidung

Gender differences in mortality among statin users aged 80 years or more

Schmerz und Alter

Nichtmedikamentöse Schmerztherapie bei chronischem Schmerz

Combined treatment with alendronate and Drynaria rhizome extracts