Anemia and comorbidity in people over 65: data from the Russian study EUCALYPTUS

Background. Anemia is an essential component of comorbidity, being both a complication of chronic diseases and a factor in their progression. Comorbidity patients with low hemoglobin have a greater number of diseases, worse geriatric status parameters and the lowest survival. Especially negative consequences of a decrease in hemoglobin were noted in people of the older age group. Aim. To investigate the relationship between anemia and comorbidity in patients aged 65 years and older. Materials and methods. The results of a sub-analysis of the multicenter cross-sectional study EUCALYPTUS, which involved 4308 people (30% of men) aged 65 to 107 years (average age – 78 years), are presented. The comorbidity was assessed and the Charlson comorbidity index was calculated, and the complete blood count was studied. Results. The frequency of comorbidity was 89%, anemia – 24%. The value of the Charlson comorbidity index in patients with anemia was greater than in those without anemia – 5 (4; 7) vs. 4 (3; 6) points (p0.001). For every 1-point increase in Charlson index values, the odds of having anemia increase by 21% (odds ratio 1.21; 95% confidence interval 1.17–1.25; p0.001). Multivariate regression analysis identified 9 independent predictors of anemia (age ≥82 years, male, history of myocardial infarction and stroke, peptic ulcer disease, atrial fibrillation, stage 4 and 5 chronic kidney disease, active cancer, no hypertension) with an odds ratio of 1.25 to 3.14. In the presence of 2–4 predictors, the risk of anemia increases 1.3–2.6 times, 5 predictors – almost 5 times, 6 or more – almost 13 times. Conclusion. Comorbidity patients are at risk for the development of anemia, which requires timely treatment, including iron supplements if absolute or functional iron deficiency is confirmed.