This community-based study investigated anemia prevalence and certain hematologic features and their possible relationships to thalassemia and iron deficiency (ID) in a population of older people in Northeastern Thailand. Participants included 319 apparently healthy individuals ranging in age from 60 to 98 years, whose current health status was assessed by means of personal interviews. Blood samples were also collected to determine the following parameters: red blood cell indices, serum ferritin, C-reactive protein, hemoglobin profiles, and the α0-thalassemia gene. Based upon established WHO criteria, the overall prevalence of anemia was found to be 47.7%, increasing from 39% within the age group of 60-70 years to 68% in those >80 years. Factors considered to be significant contributors to anemia were classified as ID (3.6%), thalassemia (56.2%), and “unknown” (40.1%). Overall, only 2.4% of participants exhibited any ID. Hematologic changes appear to correlate with age. Our findings provide not only baseline information, potentially useful for implementing appropriate control measures, but also an enhanced awareness and understanding of the factors contributing to anemia among the elderly in the region.

1.
World Health Organization: Iron Deficiency Anaemia: Assessment, Prevention, and Control: a Guide for Programme Managers. Geneva, WHO, 2001.
2.
Semba RD: Selenium; in Kraemer K, Zinnermann MB (eds): Nutritional Anemia. Basel, Sight and Life Press, 2007, p 190.
3.
Gaskell H, Derry S, Andrew Moore R, McQuay HJ: Prevalence of anaemia in older persons: systematic review. BMC Geriatr 2008;8:1.
4.
Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC: Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004;104:2263-2268.
5.
Ferrucci L, Guralnik JM, Bandinelli S, Semba RD, Lauretani F, Corsi A, Ruggiero C, Ershler WB, Longo DL: Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro-inflammatory markers. Br J Haematol 2007;136:849-855.
6.
Tettamanti M, Lucca U, Gandini F, Recchia A, Mosconi P, Apolone G, Nobili A, Tallone MV, Detoma P, Giacomin A, Clerico M, Tempia P, Savoia L, Fasolo G, Ponchio L, Della Porta MG, Riva E: Prevalence, incidence and types of mild anemia in the elderly: the “Health and Anemia” population-based study. Haematologica 2010;95:1849-1856.
7.
World Health Organization: The Global Prevalence of Anaemia in 2011. Geneva, WHO, 2015.
8.
Sanchaisuriya K, Fucharoen S, Ratanasiri T, Sanchaisuriya P, Fucharoen G, Dietz E, Schelp FP: Thalassemia and hemoglobinopathies rather than iron deficiency are major causes of pregnancy-related anemia in northeast Thailand. Blood Cells Mol Dis 2006;37:8-11.
9.
Pansuwan A, Fucharoen G, Fucharoen S, Himakhun B, Dangwiboon S: Anemia, iron deficiency and thalassemia among adolescents in Northeast Thailand: results from two independent surveys. Acta Haematol 2011;125:186-192.
10.
Carnley BP, Prior JF, Gilbert A, Lim E, Devenish R, Sing H, Sarin E, Guhadasan R, Sullivan SG, Wise CA, Bittles AH, Chan K, Wong MS, Chan V, Erber WN: The prevalence and molecular basis of hemoglobinopathies in Cambodia. Hemoglobin 2006;30:463-470.
11.
Cook JD: Iron-deficiency anaemia. Baillieres Clin Haematol 1994;7:787-804.
12.
Siriratmanawong N, Fucharoen G, Sanchaisuriya K, Ratanasiri T, Fucharoen S: Simultaneous PCR detection of beta-thalassemia and alpha-thalassemia 1 (SEA type) in prenatal diagnosis of complex thalassemia syndrome. Clin Biochem 2001;34:377-380.
13.
Expert Consultation World Health Organization: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-163.
14.
Choi CW, Lee J, Park KH, Yoon SY, Choi IK, Oh SC, Seo JH, Kim BS, Shin SW, Kim YH, Kim JS: Prevalence and characteristics of anemia in the elderly: cross-sectional study of three urban Korean population samples. Am J Hematol 2004;77:26-30.
15.
Yamada M, Wong FL, Suzuki G: Longitudinal trends of hemoglobin levels in a Japanese population - RERF's Adult Health Study subjects. Eur J Haematol 2003;70:129-135.
16.
Wang JL, Shaw NS: Iron status of the Taiwanese elderly: the prevalence of iron deficiency and elevated iron stores. Asia Pac J Clin Nutr 2005;14:278-284.
17.
Denny SD, Kuchibhatla MN, Cohen HJ: Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med 2006;119:327-334.
18.
Penninx BW, Pahor M, Woodman RC, Guralnik JM: Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci 2006;61:474-479.
19.
Price EA, Mehra R, Holmes TH, Schrier SL: Anemia in older persons: etiology and evaluation. Blood Cells Mol Dis 2011;46:159-165.
20.
Artz AS, Thirman MJ: Unexplained anemia predominates despite an intensive evaluation in a racially diverse cohort of older adults from a referral anemia clinic. J Gerontol A Biol Sci Med Sci 2011;66:925-932.
21.
Joosten E, Pelemans W, Hiele M, Noyen J, Verhaeghe R, Boogaerts MA: Prevalence and causes of anaemia in a geriatric hospitalized population. Gerontology 1992;38:111-117.
22.
Rockey DC, Cello JP: Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med 1993;329:1691-1695.
23.
Herbert V: Recommended dietary intakes (RDI) of iron in humans. Am J Clin Nutr 1987;45:679-686.
24.
Finch CA: Body iron exchange in man. J Clin Invest 1959;38:392-396.
25.
Stabler SP, Allen RH: Vitamin B12 deficiency as a worldwide problem. Annu Rev Nutr 2004;24:299-326.
26.
Andert CU, Sanchaisuriya P, Sanchaisuriya K, Schelp FP, Schweigert FJ: Nutritional status of pregnant women in Northeast Thailand. Asia Pac J Clin Nutr 2006;15:329-334.
27.
Assantachai P, Lekhakula S: Epidemiological survey of vitamin deficiencies in older Thai adults: implications for national policy planning. Public Health Nutr 2007;10:65-70.
28.
Prayurahong B, Tungtrongchitr R, Chanjanakijskul S, Lertchavanakul A, Supawan V, Pongpaew P, Vudhivai N, Hempfling AA, Schelp FP, Migasena P: Vitamin B12, folic acid and haematological status in elderly Thais. J Med Assoc Thai 1993;76:71-78.
29.
De Meyer T, De Buyzere ML, Langlois M, Rietzschel ER, Cassiman P, De Bacquer D, Van Oostveldt P, De Backer GG, Gillebert TC, Van Criekinge W, Bekaert S: Lower red blood cell counts in middle-aged subjects with shorter peripheral blood leukocyte telomere length. Aging Cell 2008;7:700-705.
30.
Gale RE, Fielding AK, Harrison CN, Linch DC: Acquired skewing of X-chromosome inactivation patterns in myeloid cells of the elderly suggests stochastic clonal loss with age. Br J Haematol 1997;98:512-519.
31.
Kikuchi M, Inagaki T, Shinagawa N: Five-year survival of older people with anemia: variation with hemoglobin concentration. J Am Geriatr Soc 2001;49:1226-1228.
32.
McNamee T, Hyland T, Harrington J, Cadogan S, Honari B, Perera K, Fitzgerald AP, Perry IJ, Cahill MR: Haematinic deficiency and macrocytosis in middle-aged and older adults. PLoS One 2013;8:e77743.
33.
Ferrucci L, Maggio M, Bandinelli S, Basaria S, Lauretani F, Ble A, Valenti G, Ershler WB, Guralnik JM, Longo DL: Low testosterone levels and the risk of anemia in older men and women. Arch Intern Med 2006;166:1380-1388.
34.
Fucharoen G, Sanchaisuriya K, Sae-ung N, Dangwibul S, Fucharoen S: A simplified screening strategy for thalassaemia and haemoglobin E in rural communities in south-east Asia. Bull World Health Organ 2004;82:364-372.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.