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Prevalence and incidence of iron deficiency in European community-dwelling older adults : An observational analysis of the DO-HEALTH trial
Stahl-Gugger, Alenka de Godoi Rezende Costa Molino, Caroline Wieczorek, Maud Chocano-Bedoya, Patricia O. Abderhalden, Lauren A. Schaer, Dominik J. Spahn, Donat R. Orav, E. John Vellas, Bruno da Silva, José A. P.
Stahl-Gugger, Alenka
de Godoi Rezende Costa Molino, Caroline
Wieczorek, Maud
Chocano-Bedoya, Patricia O.
Abderhalden, Lauren A.
Schaer, Dominik J.
Spahn, Donat R.
Orav, E. John
Vellas, Bruno
da Silva, José A. P.
Author
Stahl-Gugger, Alenka
de Godoi Rezende Costa Molino, Caroline
Wieczorek, Maud
Chocano-Bedoya, Patricia O.
Abderhalden, Lauren A.
Schaer, Dominik J.
Spahn, Donat R.
Orav, E. John
Vellas, Bruno
da Silva, José A. P.
Kressig, Reto W.
Egli, Andreas
Bischoff-Ferrari, Heike A.
Guyonnet, Sophie
Rizzoli, René
Biver, Emmanuel
Merminod, Fanny
Bridenbaugh, Stephanie
Suhm, Norbert
Silva, José A. P.
Duarte, Cátia C. M.
Felsenberg, Dieter
Börst, Hendrikje
Armbrecht, Gabriele
Blauth, Michael
Spicher, Anna
Felson, David T.
Kanis, John A.
McCloskey, Eugene V.
Johansson, Elena
Watzl, Bernhard
Hofbauer, Lorenz
Tsourdi, Elena
Rauner, Martina
Siebert, Uwe
Ferrari, Stephen M.
Gut, Benno
Ba, Marième
Etheve, Stéphane
Eggersdorfer, Manfred
Reuschling, Monika
Willett, Walter C.
Manson, JoAnn E.
Dawson-Hughes, Bess
Staehelin, Hannes B.
Walter, Paul W.
Dick, Walter
Fried, Michael
Eckardstein, Arnold
Theiler, Robert
Simmen, Hans-Peter
Langhans, Wolfgang
Zinkernagel, Annelies
Mueller, Nicolas
Distler, Oliver
Graetz, Klaus
Nitschke, Ina
Dietrich, Thomas
Baer, Walter
Landau, Klara
Ruschitzka, Frank
Manz, Markus
Burckhardt, Peter
de Godoi Rezende Costa Molino, Caroline
Wieczorek, Maud
Chocano-Bedoya, Patricia O.
Abderhalden, Lauren A.
Schaer, Dominik J.
Spahn, Donat R.
Orav, E. John
Vellas, Bruno
da Silva, José A. P.
Kressig, Reto W.
Egli, Andreas
Bischoff-Ferrari, Heike A.
Guyonnet, Sophie
Rizzoli, René
Biver, Emmanuel
Merminod, Fanny
Bridenbaugh, Stephanie
Suhm, Norbert
Silva, José A. P.
Duarte, Cátia C. M.
Felsenberg, Dieter
Börst, Hendrikje
Armbrecht, Gabriele
Blauth, Michael
Spicher, Anna
Felson, David T.
Kanis, John A.
McCloskey, Eugene V.
Johansson, Elena
Watzl, Bernhard
Hofbauer, Lorenz
Tsourdi, Elena
Rauner, Martina
Siebert, Uwe
Ferrari, Stephen M.
Gut, Benno
Ba, Marième
Etheve, Stéphane
Eggersdorfer, Manfred
Reuschling, Monika
Willett, Walter C.
Manson, JoAnn E.
Dawson-Hughes, Bess
Staehelin, Hannes B.
Walter, Paul W.
Dick, Walter
Fried, Michael
Eckardstein, Arnold
Theiler, Robert
Simmen, Hans-Peter
Langhans, Wolfgang
Zinkernagel, Annelies
Mueller, Nicolas
Distler, Oliver
Graetz, Klaus
Nitschke, Ina
Dietrich, Thomas
Baer, Walter
Landau, Klara
Ruschitzka, Frank
Manz, Markus
Burckhardt, Peter
Abstract
Background and aim
Iron deficiency is associated with increased morbidity and mortality in older adults. However, data on its prevalence and incidence among older adults is limited. The aim of this study was to investigate the prevalence and incidence of iron deficiency in European community-dwelling older adults aged ≥ 70 years.
Methods
Secondary analysis of the DO-HEALTH trial, a 3-year clinical trial including 2157 community-dwelling adults aged ≥ 70 years from Austria, France, Germany, Portugal and Switzerland. Iron deficiency was defined as soluble transferrin receptor (sTfR) > 28.1 nmol/L. Prevalence and incidence rate (IR) of iron deficiency per 100 person-years were examined overall and stratified by sex, age group, and country. Sensitivity analysis for three commonly used definitions of iron deficiency (ferritin < 45 μg/L, ferritin < 30 μg/L, and sTfR–ferritin index > 1.5) were also performed.
Results
Out of 2157 participants, 2141 had sTfR measured at baseline (mean age 74.9 years; 61.5% women). The prevalence of iron deficiency at baseline was 26.8%, and did not differ by sex, but by age (35.6% in age group ≥ 80, 29.3% in age group 75–79, 23.2% in age group 70–74); P < 0.0001) and country (P = 0.02), with the highest prevalence in Portugal (34.5%) and the lowest in France (24.4%). As for the other definitions of iron deficiency, the prevalence ranged from 4.2% for ferritin < 30 µg/L to 35.3% for sTfR–ferritin index > 1.5. Occurrences of iron deficiency were observed with IR per 100 person-years of 9.2 (95% CI 8.3–10.1) and did not significantly differ by sex or age group. The highest IR per 100 person-years was observed in Austria (20.8, 95% CI 16.1–26.9), the lowest in Germany (6.1, 95% CI 4.7–8.0). Regarding the other definitions of iron deficiency, the IR per 100 person-years was 4.5 (95% CI 4.0–4.9) for ferritin < 45 µg/L, 2.4 (95% CI 2.2–2.7) for ferritin < 30 µg/L, and 12.2 (95% CI 11.0–13.5) for sTfR–ferritin index > 1.5.
Conclusions
Iron deficiency is frequent among relatively healthy European older adults, with people aged ≥ 80 years and residence in Austria and Portugal associated with the highest risk.
Keywords
iron deficiency, prevalence, incidence, community-dwelling older adults, Europe
Date
2022
Type
Journal article
Journal
Aging Clinical and Experimental Research
Book
Volume
34
Issue
9
Page Range
2205-2215
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open