European Geriatric Medicine

, Volume 9, Issue 3, pp 395–397 | Cite as

Anemia in the aged is not ageing related: position paper on anemia in the aged by the “working group anemia” of the German Geriatric Society (DGG)

  • Gabriele Röhrig
  • Ines Gütgemann
  • Gerald Kolb
  • Andreas Leischker
Special Article


Anemia in the aged is a frequent but still under-estimated problem in geriatric patients. However, in recent years increasing research on anemia in the aged has improved awareness and interest in this clinically relevant problem. Guidelines for diagnostic and therapeutic steps are now required to improve the treatment of anemic aged patients. For encouraging the development of diagnostic and therapeutic recommendations, the “working group anemia” of the German Geriatric Society (DGG) has issued a position paper on anemia in the aged, based on the current literature. The statements are (1) that anemia has to be considered a highly prevalent but not a physiologic finding in aged persons; (2) that reference values for hemoglobin concentration are independent of age, indicating that WHO reference values for anemia definition are valid for aged persons; (3) that anemia in the aged is associated with functional and cognitive impairment based on comprehensive geriatric assessment (CGA), requiring diagnosis and treatment.


Anemia Geriatrics Position paper 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informend consent

For this type of study formal consent is not required.


  1. 1.
    Andro M, Le Squere P, Estivin S, Gentric A (2013) Anaemia and cognitive performances in the elderly: a systematic review. Eur J Neurol 20(9):1234–1240. CrossRefPubMedGoogle Scholar
  2. 2.
    Bach V, Schruckmayer G, Sam I, Kemmler G, Stauder R (2014) Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Clin Interv Aging 22(9):1187–1196. Google Scholar
  3. 3.
    Beutler E, Waalen J (2006) The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 107(5):1747–1750CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Contreras M, Formiga F, Ferrer A, Chivite D, Padrós G, Montero A, Grupo Octabaix (2015) Profile and prognosis of patients over 85 years old with anemia living in the community. Octabaix Study. Rev Esp Geriatr Gerontol 50(5):211–215. CrossRefGoogle Scholar
  5. 5.
    Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR (2006) Impact of anemia on hospitalization and mortality in older adults. Blood 107(10):3841–3846CrossRefPubMedGoogle Scholar
  6. 6.
    Gaskell H, Derry S, Andrew Moore R, McQuay HJ (2008) Prevalence of anaemia in older persons: systematic review. BMC Geriatr 14(8):1. CrossRefGoogle Scholar
  7. 7.
    Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC (2004) Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 104(8):2263–2268CrossRefPubMedGoogle Scholar
  8. 8.
    Hastka J, Heimpel H, Metzgeroth G (2011) Iron deficiency and iron deficiency anemia (Eisenmangel und Eisenmangelanämie) Onkopedia guideline: Accessed 20 Jan 2018
  9. 9.
    Hong CH, Falvey C, Harris TB, Simonsick EM, Satterfield S, Ferrucci L, Metti AL, Patel KV, Yaffe K (2013) Anemia and risk of dementia in older adults: findings from the Health ABC study. Neurology 81(6):528–533CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Leischker A, Fetcher S, Kolb GF (2016) Anaemia in the elderly. Dtsch Med Wochenschr 141(13):954–959CrossRefPubMedGoogle Scholar
  11. 11.
    Röhrig G, Schulz RJ (2012) Anemia in the elderly. Urgent need for guidelines. Z Gerontol Geriatr 45(3):182–185CrossRefPubMedGoogle Scholar
  12. 12.
    Röhrig G, Becker I, Schulz RJ, Lenzen-Großimlinghaus R, Willschrei P, Gebauer S, Modreker M, Jäger M, Wirth R (2016) Association between hematologic parameters and functional impairment among geriatric inpatients: data of a prospective cross-sectional multicenter study (“GeriPrävalenz2013”). Maturitas 90:37–41. CrossRefPubMedGoogle Scholar
  13. 13.
    Röhrig G, Hörter M, Becker I, Adams A, Gebauer S, Jäger M, Lenzen-Grossimlinghaus R, Modreker MK, Schulz RJ, Willschrei HP, Wirth R (2016) Anemia and hematologic parameters in older patients: results of a German multicentric cross-sectional study. Eur Geriat Med 7(4):328–332CrossRefGoogle Scholar
  14. 14.
    Röhrig G, Klossok W, Becker I, Benzing T, Schulz RJ (2014) Prevalence of anemia among elderly patients in an emergency room setting. Eur Geriatr Med 5(1):3–7CrossRefGoogle Scholar
  15. 15.
    Röhrig G, Becker I, Gutensohn K, Nebe T. Red blood cell counts and indices in the elderly German population. Accepted by Journal of Laboratory Medicine No. JLM.2017.0080.R2 on 4.11.2017Google Scholar
  16. 16.
    Saad F, Röhrig G, von Haehling S, Traish A (2017) Testosterone deficiency and testosterone treatment in older men. Gerontology 63(2):144–156CrossRefPubMedGoogle Scholar
  17. 17.
    Romero-Ruperto S, Pérez-Bocanegra MC, Duran-Taberna M, Toscano-Rivera A, Barbé-Gil Ortega J, San José-Laporte A (2015) Anemia in elderly patients admitted to an acute geriatric ward. Rev Esp Geriatr Gerontol. 50(3):122–125. CrossRefPubMedGoogle Scholar
  18. 18.
    Umegaki H, Yanagawa M, Endo H (2011) Association of lower hemoglobin level with depressive mood in elderly women at high risk of requiring care. Geriatr Gerontol Int. 11(3):262–266. CrossRefPubMedGoogle Scholar
  19. 19.
    World Health Organization (1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37Google Scholar
  20. 20.
    Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, Cushman M (2005) A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med 165(19):2214–2220CrossRefPubMedGoogle Scholar
  21. 21.
    Zamboni V, Cesari M, Zuccalà G, Onder G, Woodman RC, Maraldi C, Ranzini M, Volpato S, Pahor M, Bernabei R (2006) Anemia and cognitive performance in hospitalized older patients: results from the GIFA study. Int J Geriatr Psychiatry 21(6):529–534CrossRefPubMedGoogle Scholar
  22. 22.
    Zilinski J, Zillmann R, Becker I, Benzing T, Schulz RJ, Roehrig G (2014) Prevalence of anemia among elderly inpatients and its association with multidimensional loss of function. Ann Hematol 93(10):1645–1654. CrossRefPubMedGoogle Scholar

Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  1. 1.Geriatric Diagnostic Center, MVZ Medicum Köln OstCologneGermany
  2. 2.Institute of PathologyUniversity Hospital BonnBonnGermany
  3. 3.Medizinische Klinik FB GeriatrieBonifatius Hospital Lingen (Ems)LingenGermany
  4. 4.Klinik für Geriatrie, Alexianer Krefeld GmbH und Klinik für Geriatrische Rehabilitation, Alexianer Tönisvorst GmbHTönisvorstGermany

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