Nonanemic absolute iron deficiency (NAID) may be associated with an increased risk for mortality among elderly adults in England, according to research published in the British Journal of Haematology.
Although iron deficiency with anemia is linked to increased risk for mortality, the prevalence of NAID and the risks it poses are not well established. There is some evidence, however, that NAID is associated with reduced physical performance, reduced exercise capacity, and an increased risk for hospital readmission.
For this study, researchers evaluated the prevalence of NAID using a serum ferritin threshold of less than 30 µg/L among adults aged 50 years or older in the United Kingdom and attempted to determine whether NAID increases risk for all-cause mortality.
Of 5367 adults who provided data, data from 4451 were used in this analysis. The mean overall healthy participant age (4062 participants) was 65.3 years; 54.9% of patients were female and 36.2% consumed fewer than 1 alcoholic drink per week. The mean C-reactive protein (CRP) and fibrinogen levels were 3.8 mg/L and 3.2 g/L, respectively.
Among the 389 participants (8.8%) with NAID, 68.4% were female (P <.001), 48.3% consumed fewer than 1 alcoholic drink per week (P <.001), and the mean CRP and fibrinogen levels were 2.8 mg/L and 3.1 g/L, respectively (P =.005 for both).
No other variables, including age, ethnicity, or sedentary lifestyle, were predictive of NAID.
Compared with participants without NAID, the hazard ratio for mortality among individuals with NAID was 1.58 over 14 years (95% CI, 1.29-1.93). Furthermore, this figure was robust in sensitivity analyses.
“[W]e demonstrate, in a nationally representative sample of older adults, that NAID is common and there are substantially more deaths amongst individuals with NAID,” the researchers concluded.
1. Philip KEJ, Sadaka AS, Polkey M, Hopkinson NS, Steptoe A, Fancourt D. The prevalence and associated mortality of non-anaemic iron deficiency in older adults: a 14 years observational cohort study [published online February 18, 2020]. Br J Haematol. doi: 10.1111/bjh.16409