medigraphic.com
Instituto Nacional de Salud Pública

2021, Número 3

<< Anterior Siguiente >>

salud publica mex 2021; 63 (3)


La deficiencia de hierro no es el principal contribuyente a la anemia en adultos mayores participantes en la Ensanut 2018-19

De la Cruz-Góngora V, Rivera-Pasquel M, Shamah-Levy T, Villalpando-Hernández S

Idioma: Ingles.
Referencias bibliográficas: 49
Paginas: 412-421
Archivo PDF: 276.02 Kb.


RESUMEN

Objetivo. Describir la situación actual de deficiencia de hierro (DH), anemia y características asociadas en adultos mayores (AM). Material y métodos. Se analizó información de 2 902 AM de la Ensanut 2018-19. Deficiencia de hierro se definió: s-ferritina‹15 µg/L y anemia de acuerdo con el criterio de la Organización Mundial de la Salud. Se emplearon modelos de regresión logística para identificar las características asociadas con la DH y anemia en los AM. Resultados. La prevalencia de anemia fue de 28.4%, DH 5% y anemia por DH 2.07%. Diabetes (RM=2.14), insuficiencia renal (RM=10.4), la mayor edad y habitar en localidades urbanas (RM=1.35) se asociaron a mayor momio para anemia (p‹0.05). El grupo de edad de 70-79 años fue la única característica asociada a mayor probabilidad de DH (RM=1.86, p‹0.05). Conclusiones. La anemia afecta a una proporción de los AM sin tener como principal causa a la DH. Algunas comorbilidades crónicas explican el problema de la anemia en esta población.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. World Health Organization. Nutrition for Older Persons. Agein and nutrition: a growing global challenge. Geneva: WHO, 2015 [cited July 13, 2020]. Available from: https://www.who.int/nutrition/topics/ageing/en/

  2. Instituto Nacional de Estadística y Geografía. Estadísticas a propósito del día internacional de las personas de edad (1° de octubre). Datos nacionales. Mexico City: INEGI, 2019 [cited July 13, 2020]. Available from: https://www.inegi.org.mx/contenidos/saladeprensa/aproposito/2019/ edad2019_Nal.pdf

  3. Marsman D, Belsky DW, Gregori D, Johnson MA, Low-Dog T, Meydani S, et al. Healthy ageing: the natural consequences of good nutrition— a conference report. Eur J Nutr. 2018;57(Suppl 2):15-34. https://doi. org/10.1007/s00394-018-1723-0

  4. Busti F, Campostrini N, Martinelli N, Girelli D. Iron deficiency in the elderly population, revisited in the hepcidin era. Front Pharmacol. 2014;5(83):1-9. https://doi.org/10.3389/fphar.2014.00083

  5. Hsu HS, Li CI, Liu CI, Liu CS, Lin CC, Huang KC, et al. Iron deficiency is associated with increased risk for cardiovascular disease and all-cause mortality in the elderly living in long-term care facilities. Nutrition. 2013;29(5):737-43. https://doi.org/10.1016/j.nut.2012.10.015

  6. Parikh A, Natarajan S, Lipsitz SR, Katz SD. Iron deficiency in communitydwelling US adults with self-reported heart failure in the National Health and Nutrition Examination Survey III: prevalence and associations with anemia and inflammation. Circ Heart Fail. 2011;4(5):599-606. https://doi.org/10.1161/CIRCHEARTFAILURE.111.960906

  7. Hong-Bae K, Byoungjin P, Jae-Yong S. Anemia in association with cognitive impairment: a systematic review and meta-analysis. J Alzheimers Dis. 2019;72(3):803-14. https://doi.org/10.3233/JAD-190521

  8. Penninx BWJH, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc. 2004;52(5):719-24. https://doi.org/10.1111/j.1532-5415.2004.52208.x

  9. Penninx BWJH, Pluijm SMF, Lips P, Woodman R, Miedema K, Guralnik JM, et al. Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc. 2005;53(12):2106-11. https://doi.org/10.1111/j.1532- 5415.2005.00491.x

  10. De la Cruz-Góngora V, Manrique-Espinoza B, Villalpando S, Téllez- Rojo-Solís MM, Salinas-Rodriguez A. Short-term impact of anemia on mortality: evidence from a sample of Mexican older adults. J Aging Health. 2014;26(5):750-65. https://doi.org/10.1177/0898264314529331

  11. Gutierrez JP, Rivera-Dommarco J, Shamah-Levy T, Villalpando-Hernandez S, Franco A, Cuevas-Nasu L, et al. Encuesta Nacional de Salud y Nutricion 2012. Resultados Nacionales. Cuernavaca: Instituto Nacional de Salud Pública, 2012. Disponible en: https://ensanut.insp.mx/encuestas/ensanut2012/ doctos/informes/ENSANUT2012ResultadosNacionales.pdf

  12. Weiss G. Anemia of chronic disorders: new diagnostic tools and new treatment strategies. Semin Hematol. 2015;52(4):313-20. https://doi. org/10.1053/j.seminhematol.2015.07.004

  13. Romero-Martínez M, Shamah-Levy T, Vielma-Orozco E, Heredia- Hernández O, Mojica-Cuevas J, Cuevas-Nasu L, et al. Encuesta Nacional de Salud y Nutrición 2018-19: metodología y perspectivas. Salud Publica Mex. 2019;61(6):917-23. https://doi.org/10.21149/11095

  14. Arokiasamy P, Uttamacharya, Kowal P, Capistrant BD, Gildner TE, Thiele E, et al. Chronic noncommunicable diseases in 6 low-and middleincome countries: findings from wave 1 of the World Health Organization’s Study on Global Ageing and Adult Health (SAGE). Am J Epidemiol. 2017;185(6):414-28. https://doi.org/10.1093/aje/kww125

  15. Salinas-Rodriguez A, De la Cruz-Góngora V, Manrique-Espinosa B. Condiciones de salud, síndromes geriátricos, y estado nutricional de los adultos mayores en México. Salud Publica Mex. 2020;62(6):777-85. https:// doi.org/10.21149/11840

  16. Paudel S, Sharma P, Puri N. Immunosenescence, inflammaging, and their implications for cancer and anemia. In: Rath P. Molecules and Mechanisms in Biogerontology. Singapore: Springer, 2019:297-319. https://doi. org/10.1007/978-981-13-3585-3_14

  17. Lohman TG, Roche AF, Martorell R. Anthropometric standarization reference manual. Champlaign, IL: Human Kinetics, 1988.

  18. Habicht JP. Estandarización de métodos epidemiológicos cuantitativos sobre el terreno. Boletín de la Oficina Sanitaria Panamericana (OSP) 1974;76(5):375-84. Available from: https://iris.paho.org/bitstream/ handle/10665.2/10766/v76n5p375.pdf?sequence=1

  19. Rosalind S. Gibson. Anthropometric assessment of body size. In: Rosalind S. Gibson. Principles of nutritional assessment. 2nd ed. New York: Oxford University Press, 2005;259-64.

  20. Thurnham DI, McCabe LD, Haldar S, Wieringa FT, Northrop-Clewes CA, McCabe GP. Adjusting plasma ferritin concentrations to remove the effects of subclinical inflammation in the assessment of iron deficiency: a meta-analysis. Am J Clin Nutr. 2010;92(3):546-55. https://doi.org/10.3945/ ajcn.2010.29284

  21. Cohen JH, Haas JD. Hemoglobin correction factors for estimating the prevalence of iron deficiency anemia in pregnant women residing at high altitudes in Bolivia. Rev Panam Salud Publica 1999;6(6):392-99. https://doi. org/10.1590/s1020-49891999001100004

  22. World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and mineral nutrition Information system. Geneva: WHO, 2011 [cited January 13, 2021]. Available from: https://apps.who.int/iris/bitstream/handle/10665/85839/ WHO_NMH_NHD_MNM_11.1_eng.pdf?ua=1

  23. UNICEF, UNU, WHO. Iron deficiency anaemia. Assessment, prevention and control. A guide for programme managers. Geneva: WHO, 2001 [cited January 13, 2021]. Available from: https://www.who.int/nutrition/publications/ en/ida_assessment_prevention_control.pdf

  24. Contreras-Manzano A, De la Cruz V, Villalpando S, Rebollar R, Shamah- Levy T. Anemia and iron deficiency in Mexican elderly population. Results from the Ensanut 2012. Salud Publica Mex. 2015;57(5):394-402. https://doi. org/10.21149/spm.v57i5.7619

  25. Patel KV. Epidemiology of anemia in older adults. Semin Hematol. 2008;45(4):210-17. https://doi.org/10.1053/j.seminhematol.2008.06.006

  26. Franceschi C, Bonafè M, Valensin S, Olivieri F, De Luca M, Ottaviani E, et al. Inflamm-aging: an evolutionary perspective on immunosenescence. Ann N Y Acad Sci. 2000;908(1):244-54. https://doi. org/10.1111/j.1749-6632.2000.tb06651.x

  27. Nairz M, Theurl I, Wolf D, Dominik W, Weiss G. Iron deficiency or anemia of inflammation? Differential diagnosis and mechanisms of anemia of inflammation. Wien Med Wochenschrift. 2016;166(13):411-23. https:// doi.org/10.1007/s10354-016-0505-7

  28. De la Cruz-Góngora V. Causas de anemia en adultos mayores: papel de la hepcidina, vitamina A y vitamina D (thesis). Mexico: Escuela de Salud Pública de México, 2018.

  29. Robalo-Nunes A, Fonseca C, Marques F, Belo A, Brilhante D, Cortez J. Prevalence of anemia and iron deficiency in older Portuguese adults: an EMPIRE substudy. Geriatr Gerontol Int. 2017;17(11):1814-22. https://doi. org/10.1111/ggi.12966

  30. Philip KEJ, Sadaka AS, Polkey MI, 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. Br J Haematol. 2020;189(3):566-72. https://doi.org/10.1111/bjh.16409

  31. Chen-Edinboro LP, Murray-Kolb LE, Simonsick EM, Ferrucci L, Allen R, Payne ME, Spira AP. Association between non-iron-deficient anemia and insomnia symptoms in community-dwelling older adults: the Baltimore longitudinal study of aging. J Gerontol A Biol Sci Med Sci. 2018;73(3):380- 5. https://doi.org/10.1093/gerona/glw332

  32. Stewart R, Hirani V. Relationship between depressive symptoms, anemia, and iron status in older residents from a national survey population. Psychosom Med. 2012;74(2):208-13. https://doi.org/10.1097/ PSY.0b013e3182414f7d

  33. Von-Haehling S, Gremmler U, Krumm M, Mibach F, Schön N, Taggeselle J, et al. Prevalence and clinical impact of iron deficiency and anaemia among outpatients with chronic heart failure: The PrEP registry. Clin Res Cardiol. 2017;106(6):436-43. https://doi.org/10.1007/s00392-016-1073-y

  34. Yavuz BB, Cankurtaran M, Haznedaroglu IC, Halil M, Ulger Z, Altun B, Ariogul S. Iron deficiency can cause cognitive impairment in geriatric patients. J Nutr Health Aging. 2012;16(3):220-4. https://doi.org/10.1007/ s12603-011-0351-7

  35. Joosten E. Iron deficiency anemia in older adults: a review. Geriatr Gerontol Int. 2018;18(3):373-9. https://doi.org/10.1111/ggi.13194

  36. Nemeth E, Ganz T. Anemia of inflammation. Hematol Oncol Clin North Am. 2014;28(4):671-81. https://doi.org/10.1016/j.hoc.2014.04.005

  37. World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. Geneva: WHO, 2020 [cited January 13, 2021]. Available from: https://apps.who.int/ iris/handle/10665/331505

  38. Burton JK, Yates LC, Whyte L, Fitzsimons E, Stott DJ. New horizons in iron deficiency anaemia in older adults. Age Ageing. 2020;49(3):309-318. https://doi.org/10.1093/ageing/afz199

  39. Winocour P. Diabetes and chronic kidney disease: an increasingly common multi-morbid disease in need of a paradigm shift in care. Diabet Med. 2018;35(3):300-5. https://doi.org/10.1111/dme.13564

  40. Bajaj S, Makkar BM, Abichandani VK, Talwalkar PG, Saboo B, Srikanta SS, et al. Management of anemia in patients with diabetic kidney disease: a consensus statement. Indian J Endocrinol Metab. 2016;20(2):268-81. https://doi.org/10.4103/2230-8210.176348

  41. Whitehead-Jr RD, Mei Z, Mapango C, D-Jefferds ME. Methods and analyzers for hemoglobin measurement in clinical laboratories and field settings. Ann N Y Acad Sci. 2019;1450(1):147-71. https://doi.org/10.1111/nyas.14124

  42. Whitehead-Jr RD, Zhang M, Sternberg MR, Schleicher RL, Drammeh B, Mapango C, Pfeiffer CM. Effects of preanalytical factors on hemoglobin measurement: a comparison of two HemoCue® point-of-care analyzers. Clin Biochem. 2017;50(9):513-20. https://doi.org/10.1016/j.clinbiochem. 2017.04.006

  43. Jain A, Chowdhury N, Jain S. Intra-and inter-model reliability of hemocue Hb 201+ and hemocue Hb 301 devices. Asian J Transfus Sci. 2018;12(2):123-6. https://doi.org/10.4103/ajts.AJTS_119_17

  44. Den-Elzen WPJ, Willems JM, Westendorp RGJ, De Craen AJM, Assendelft WJJ, Gussekloo J. Effect of anemia and comorbidity on functional status and mortality in old age: results from the leiden 85-plus study. CMAJ. 2009;181(3-4):151-7. https://doi.org/10.1503/cmaj.090040

  45. Smith-Jr RE. The clinical and economic burden of anemia. Am J Manag Care. 2010;16(3)S59-S66 [cited January 13, 2021]. Available from: https:// pubmed.ncbi.nlm.nih.gov/20297873/

  46. Michalak SS, Rupa-Matysek J, Hus I, Gil L. Unexplained anemia in the elderly-a real life analysis of 981 patients. Arch Med Sci. 2020;16(4):834-41. https://doi.org/10.5114/aoms.2019.82723

  47. World Health Organization. Global strategy and action plan on ageing and health. Geneva: WHO, 2016 [cited July 13, 2020]. Available from: https://www.who.int/ageing/WHO-GSAP-2017.pdf?ua=1

  48. World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity.Vitamin and mineral nutrition information system. Geneva: WHO, 2011 [cited July 13, 2020]. Available from: http://www.who.int/vmnis/indicators/haemoglobin. pdf

  49. Patel KV, Harris TB, Faulhaber M, Angleman SB, Connelly S, Bauer DC, et al. Racial variation in the relationship of anemia with mortality and mobility disability among older adults. Blood. 2007;109(11):4663-70. https:// doi.org/10.1182/blood-2006-10-055384




2020     |     www.medigraphic.com