Anemia of aging

Healthy Aging

A silent age accelerator

In this series, we are covering the science behind our cells and aging, how the health of our cells determines our overall health, and how extending healthy cellular survival can even extend our longevity.

Last week, we talked about how our red blood cells serve as bellwethers of how fast we age (aka, our aging rate). This week, let’s dive more into a disease on the rise: anemia of aging.

What is anemia of aging? Wait, I bet this is when you get anemia as you age.

Look at you, smarty pants. Correct – as we get older, our cells (including our red blood cells) get more fragile. And when our red blood cells become increasingly fragile, we can develop anemia of aging. The definition of anemia is a hemoglobin measurement of < 12 g/dl for women and < 13 g/dl for men.

Your odds of having this condition are…

As described by Patel, once we hit 50 years old, our likelihood of having anemia increases to about 1 in 5 people. Among older people living in healthcare facilities, the prevalence of anemia goes way up, to 50%.

Why should I care about anemia of aging?

Here are two good reasons to pay attention to anemia of aging: as reviewed by Katsumi et al., numerous studies have shown that anemia is 1) a direct indicator of our whole-body frailty, and 2) a powerful predictor of shorter life.

To better understand how anemia affects our health as we age, Salis et al. led a study with 1,698 people who were 65 years and older. In this study, they divided the population into those that did or didn’t have anemia and compared the following:

• Cognitive assessment
• Mood
• Physical abilities
• Nutritional status
• Multiple chronic illnesses

Salis et al. found that people with anemia were less mobile, had poorer nutrition status, and were more likely to have multiple chronic illnesses compared to those without anemia. Importantly, they found that a hemoglobin measurement < 13 g/dl for both men and women were indicators of increased fragility. As such, the authors recommended that hemoglobin < 13 g/dl for all older adults be used to define anemia.

Treating anemia of aging.

For a long time, physicians believed that anemia was a normal part of aging – and that anemia itself wasn’t necessarily a concern. We now know, however, that anemia among older adults is a persistent health condition that (as summarized by Guralnik et al.) needs to be addressed to decrease our risk of frailty and early death.

Current treatment is based on the type of anemia one has. If a patient isn’t producing enough red blood cells, they may be given a drug to increase red blood cell production (these are called erythropoiesis-stimulating agents). If one has severe iron deficiency anemia, they may be provided intravenous iron. As reviewed by Davies et al., however, these treatments are either not always effective or not safe for long-term use. This is why many scientists around the world are searching for safe, long-term options to effectively treat chronic anemia in older adults.