What is the prognosis of mild normocytic anaemia in older people?

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Abstract
Background:  There is reduced survival for people with all types of anaemia and it has been shown that there is a low yield from investigations for older people with normocytic anaemia. However, the longer‐term outcomes of people with mild normocytic anaemia are not known.Aims:  To determine the 5‐year prognosis of older people with mild normocytic anaemia, compared with non‐anaemic controls.Methods:  This was a prospective cohort study, with some retrospective data collection, comparing 52 people aged ≥65 years (haemoglobin 100−119 g/L; mean cell volume 80−99 fL) without an obvious cause at presentation with 52 non‐anaemic controls. The incidence of death, new malignancies and significant illnesses was compared between the two groups, 5 years later.Results:  Anaemic patients were less likely to be living at home at baseline. Although survival was lower for the anaemic group at all follow‐up times, these differences were not significantly different. Over 5 years, there were no significant differences between groups in the types of problems that developed.Conclusions:  A mild normocytic anaemia in older people, in the absence of an obvious cause, is not associated with significant differences in outcomes but is associated with poorer independence and a trend to lower survival. We suggest it may therefore be a marker of frailty in older people. (Intern Med J 2003; 33: 14−17)

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