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

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.

To determine the 5-year prognosis of older people with mild normocytic anaemia, compared with non-anaemic controls.

This was a prospective cohort study, with some retrospective data collection, comparing 52 people aged > or =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.

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.

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.