DIAGNOSIS AND TREATMENT OF IRON DEFICIENCY IN THE ELDERLY AGE
Abstract
Iron deficiency exists in 1/3 of the population and is the main cause of anemia in all regions of the world. In elderly patients, iron deficiency causes 30% of anemia. The diagnostic algorithm in patients of older age groups includes the study of ferrokinetics and the search for the cause of iron deficiency, the main of which is occult blood loss from the gastrointestinal tract and a decrease in iron absorption. For treatment, iron preparations are used orally and parenterally under the control of a clinical blood test and the parameter of ovferrokinetics.
References
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Moretti D., Goede J.S., Zeder C. et al. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily dosis in iron-depleted young women. Blood. 2015; 126: 1981–9. DOI: 10.1182/blood-2015-05-642223.
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Rockey D.C., Altayar O., Falck-Ytter Y. et al. AGA technical review on gastrointestinal evaluation of iron deficiency anemia. Gastroenterology. 2020; 159: 1097–1119. https://10.10 3/j.gastro.2020.06.045.
Röhrig G., Gütgemann I., Kolb G. et al. Anemia in the aged is not ageing related: Position paper on anemia in the aged by the “working group anemia” of the German Geriatric Society (DGG) Eur. Geriatr. Med. 2018; 9: 395–7. https://doi: 10.1007/s41999-018-0048-0.
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Romano A.D., Paglia A., Bellanti F. et al. Molecular aspects and treatment of iron deficiency in the elderly. Int J Mol Sci. 2020; 21(11): 3821. https://doi: 10.3390/ijms21113821.
Serum transferrin receptor levels for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2014 (WHO/NMH/NHD/MNM/14.6; http://apps.who.int/iris/bitstream/10665/133707/1/WHO_NMH_NHD_EPG_14.6_eng. pdf?ua=1. (accessed 10.03.2023).
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Soon A., Cohen B.L., Groessl E.J. et al. Long-term outcomes and prognostic factors for patients with endoscopy-negative iron deficiency. Dig Dis Sci. 2013; 58: 488–95. DOI: 10.1007/s10620-012-2368-0.
Stauder R., Valent P., Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood. 2018; 131 (5): 505–14. https://doi: 10.1182/blood-2017-07-746446.
Suchdev P.S., Williams A.M., Mei Z. et al. Assessment of iron status in settings of inflammation: challenges and potential approaches. Am. J. Clin. Nutr. 2017; 106: 1626–33. DOI: 10.3945/ajcn.117.155937.
WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.2). http://www.who.int/vmnis/indicators/serum_ferritin. pdf. (accessed 10.03.2023).
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Hershko C., Camaschella C. How I treat unexplained refractory iron-deficiency anemia. Blood. 2014; 123: 326–33. DOI: 10.1182/blood-2013-10-512624.
Johnson-Wimbley T.D. Diagnosis and management of iron deficiency anemia in the 21st century. Therap. Adv. Gastroenterol. 2011; 4 (3): 177–84. https://doi: 10.1177/1756283X11398736.
Joosten E. Iron deficiency anemia in older adults: a review. Geriatr Gerontol Int. 2018; 18: 373–9. DOI: 10.1111/ggi.13194.
Kassebaum N.J., Jasrasaria R., Naghavi M. et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014; 123(5): 615–24. https://doi: 10.1182/blood-2013-06-508325.
Lopez A., Cacoub P., Macdaugall I.C. Iron deficiency anaemia. Lancet. 2016; 387: 907–16. https://doi: 10.1016/S0140-6736(15)60865-0.
Manckoundia P., Konaté A., Hacquin A. et al. Iron in the general population and specificities in older adults: metabolism, causes and consequences of decrease or overload, and biological assessment. Clin Interv Aging. 2020; 15: 1927–38. https://doi: 10.2147/CIA.S269379.
Martín-Masot R., Nestares M.T., Diaz-Castro J. et al. Multifactorial etiology of anemia in celiac disease and effect of gluten-free diet: A comprehensive review. Nutrients. 2019; 11: 2557. DOI: 10.3390/nu11112557.
Merchant A.A., Roy C.N. Not so benign haematology: anaemia of the elderly. Br. J. Haematol. 2012; 156 (2): 173–85. DOI: 10.1111/j.1365-2141.2011.08920.
Moretti D., Goede J.S., Zeder C. et al. Oral iron supplements increase hepcidin and decrease iron absorption from daily or twice-daily dosis in iron-depleted young women. Blood. 2015; 126: 1981–9. DOI: 10.1182/blood-2015-05-642223.
Nairz M., Theurl I., Wolf D. et al. Differential diagnosis and mechanisms of anemia of inflammation. Wien Med Wochenschr. 2016; 166 (13): 411–23. DOI: 10.1007/s10354-016-0505-7.
Patel K.V. Epidemiology of anemia in older adults. Semin. Hematol. 2008; 45: 210–7. DOI: 10.1053/j.seminhematol.2008.06.006.
Rockey D.C., Altayar O., Falck-Ytter Y. et al. AGA technical review on gastrointestinal evaluation of iron deficiency anemia. Gastroenterology. 2020; 159: 1097–1119.https://10.10 3/j.gastro.2020.06.045.
Röhrig G., Gütgemann I., Kolb G. et al. Anemia in the aged is not ageing related: Position paper on anemia in the aged by the “working group anemia” of the German Geriatric Society (DGG) Eur. Geriatr. Med. 2018; 9: 395–7. https://doi: 10.1007/s41999-018-0048-0.
Rohrig G., Gutgemann I., Leischker A. et al. Anemia in the aged — A geriatric syndrome? Second position paper on anemia in the aged by the working group anemia of the German Geriatric Society. Z. Gerontol. Geriatr. 2018; 51: 921–3. https://doi: 10.1007/s00391-018-1457-x.
Romano A.D., Paglia A., Bellanti F. et al. Molecular aspects and treatment of iron deficiency in the elderly. Int J Mol Sci. 2020; 21(11): 3821. https://doi: 10.3390/ijms21113821.
Serum transferrin receptor levels for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2014 (WHO/NMH/NHD/MNM/14.6; http://apps.who.int/iris/ bitstream/10665/133707/1/WHO_NMH_NHD_EPG_14.6_eng. pdf?ua=1. (accessed 10.03.2023).
Snook J., Bhala N, Beales I.L. et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults.Gut. 2021; 70(11): 2030–51. DOI: 10.1136/gutjnl-2021-325210.
Soon A., Cohen B.L., Groessl E.J. et al. Long-term outcomes and prognostic factors for patients with endoscopy-negative iron deficiency. Dig Dis Sci. 2013; 58: 488–95. DOI: 10.1007/s10620-012-2368-0.
Stauder R., Valent P., Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood. 2018; 131 (5): 505–14. https://doi: 10.1182/blood-2017-07-746446.
Suchdev P.S., Williams A.M., Mei Z. et al. Assessment of iron status in settings of inflammation: challenges and potential approaches. Am. J. Clin. Nutr. 2017; 106: 1626–33. DOI: 10.3945/ajcn.117.155937.
WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.2). http://www.who.int/vmnis/indicators/serum_ferritin. pdf. (accessed 10.03.2023).
World Health Organisation. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011(WHO/NMH/NHD/MNM/11.1) http://www.who. int/vmnis/indicators/haemoglobin.pdf.
Yiannikourides A., Latunde-Dada G.O. A short review of iron metabolism and pathophysiology of iron disorders. Medicines (Basel). 2019; 6(3): 85. DOI: 10.3390/medicines6030085.
