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 highgly prevalent among elderly and few previous studies have focused on hospitalized medical patients aged ≥ 75 years. During a four-months period of this single center prospective cohort study, 508 patients were admitted and studied with a standardized set of blood tests. Anemia, defined as by WHO, was present in 277 (54.5%) and in the majority of cases was mild (71.8%), normocytic (82.8%), hypoproliferative (90.5%). 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 deficiency 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.