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- Title
Disentangling Anemia in Frailty: Exploring the Role of Inflammation.
- Authors
Herpich, Catrin; Göger, Lea; Faust, Lea; Kalymon, Magdalena; Ott, Christiane; Walter, Sophia; Lehmkuhl, Elke; Grune, Tilman; Moskiou, Varvara; Müller-Werdan, Ursula; Norman, Kristina
- Abstract
Background In older patients, frailty and anemia frequently coexist. However, only few studies have been conducted in older patients with multimorbidity and several overlapping causes of anemia, such as inflammation, inadequate nutrition, or certain pathologies. This analysis aims to decipher potential factors associated with anemia in older hospital patients with frailty. Methods Patients (n = 208, age: 62–98 years) were categorized as prefrail (n = 68) and frail (n = 140) using the Fried frailty phenotype. We quantified serum concentrations of markers of iron metabolism (iron, ferritin, transferrin, soluble transferrin receptor, and hepcidin), inflammation (interleukin [IL]-6 and IL-10 C-reactive protein), and hematology (hemoglobin). Principal component analysis was conducted to evaluate biomarker patterns and associations with frailty were assessed with logistic regression analysis. Results Anemia prevalence was higher in patients with frailty (84.3% vs 70.6%, p = .021). Three principal components (PC1–3) were identified. PC1 was characterized by high factor loadings representing inflammation and factor scores differed between patients with prefrailty and frailty (−0.04 (interquartile range [IQR]: 1.45) vs −0.51 (IQR: 0.87), p < .001]. PC2 represents macrocytic anemia and thus vitamin B12 or folate deficiency, whereas PC3 indicates hematological pathologies. Only PC1 was associated with frailty status when controlled for age, sex, number of drugs, and comorbidities (OR: 2.018, 95% CI: 1.316; 3.094, p = .001). PC2 and PC3 were not associated with frailty. Conclusions Our results suggest that anemia in patients with frailty is driven by inflammation rather than being disease-related or solely the result of micronutrient deficiencies.
- Subjects
VITAMIN B12 deficiency; TRANSFERRIN receptors; OLDER patients; LOGISTIC regression analysis; PRINCIPAL components analysis
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2024, Vol 79, Issue 12, p1
- ISSN
1079-5006
- Publication type
Academic Journal
- DOI
10.1093/gerona/glae243