The anemia of the old and oldest-old patients hospitalized in Internal Medicine: a very high rate of anemia of chronic disease and multifactorial anemia

Anemia is highly prevalent among the elderly, and few previous studies have focused on hospitalized medical patients aged ‰¥75 years. During the four months of this single-center prospective cohort study, 508 patients were admitted and studied with a standardized set of blood tests. Anemia, as defined by the World Health Organization, was present in 277 (54.5%) patients; in the majority of cases it was mild (71.8%), normocytic (82.8%), and hypoproliferative (90.5%). The most frequent diagnosis was multifactorial anemia (47.7%); anemia of chronic disease was the most frequent single cause (28.5%) and the most frequent etiologic co-factor among multifactorial anemia. Iron deficiency was found in 22.7% of cases; vitamin B12 and folate deficiencies were found in 7.5% and 26.1%, respectively; chronic kidney disease in 16.2%; overt bleeding anemias in 4.8% and clonal hemopathies in 3.2%. Unexplained anemia was diagnosed only in 5.1% of cases. The finding of a very high frequency of anemia of chronic disease and multifactorial anemia has implications on both the diagnostic and therapeutic grounds.