title: Prevalence of anemia and iron deficiency in older Portuguese adults: An EMPIRE substudy.
abstract: OBJECTIVE
  The present study aimed to characterize the prevalence of anemia and iron deficiency in older Portuguese adults, and to compare it with the prevalence in younger individuals.
  
  
  METHODS
  A population-based, cross-sectional study (EMPIRE study) enrolling a representative sample of 6267 adults aged <65 years and 1617 adults aged ≥65 years was carried out. Hemoglobin, ferritin, creatinine and C-reactive protein levels were measured by Point-of-Care tests.
  
  
  RESULTS
  Anemia was more prevalent (P < 0.001) in participants aged ≥80 years (31.4%) compared with participants aged <65 years (19.6%) and 65-79 years (17.3%). At a 30-ng/mL ferritin cut-off, iron deficiency was more prevalent in participants aged ≥80 years (42.8%) compared with participants aged <65 years (31.5%) and 65-79 years (30.2%). Alternative ferritin cut-offs showed overall similar patterns. Anemia and iron deficiency were significantly more prevalent in older individuals who self-reported heart failure, coronary heart disease and gastritis. Anemia was more prevalent in participants aged <65 years in the north of Portugal and participants aged ≥65 years in central Portugal, following the prevalence of iron deficiency in the regions. In all regions, anemia was more prevalent in participants aged ≥80 years (reaching 39.0% in Lisbon and Tagus Valley, and 51.0% in the south).
  
  
  CONCLUSIONS
  Anemia and iron deficiency are highly prevalent in older Portuguese adults, particularly among those aged ≥80 years. Better diagnosis, prevention and treatment strategies should be implemented taking into account the outstanding role of iron deficiency in older Portuguese adults, the differences between regions and the intrinsic characteristics of this population. Geriatr Gerontol Int 2017; 17: 1814-1822.
authors.affiliation: Anemia Working Group - Portugal, Lisbon, Portugal.|Geriatric University Unit, Lisbon University Medical School, Lisbon, Portugal.|Northern Lisbon Hospital Center, Lisbon, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Robalo Nunes
authors.affiliation: Anemia Working Group - Portugal, Lisbon, Portugal.|West Lisbon Hospital Center, Lisbon, Portugal.|NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal.
authors.forename: Cândida
authors.initials: C
authors.lastname: Fonseca
authors.affiliation: Anemia Working Group - Portugal, Lisbon, Portugal.|West Lisbon Hospital Center, Lisbon, Portugal.|NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Marques
authors.affiliation: Anemia Working Group - Portugal, Lisbon, Portugal.
authors.forename: Aurora
authors.initials: A
authors.lastname: Belo
authors.affiliation: Anemia Working Group - Portugal, Lisbon, Portugal.|Francisco Gentil Portuguese Institute of Oncology, Lisbon Center, Lisbon, Portugal.
authors.forename: Dialina
authors.initials: D
authors.lastname: Brilhante
authors.affiliation: Anemia Working Group - Portugal, Lisbon, Portugal.|NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal.|Francisco Gentil Portuguese Institute of Oncology, Lisbon Center, Lisbon, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Cortez
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006801:Humans; D000090463:Iron Deficiencies; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence
keywords: Portugal; anemia; epidemiology; iron deficiency; older adults