Iron in the General Population and Specificities in Older Adults: Metabolism, Causes and Consequences of Decrease or...

Area of Science:

• Gerontology
• Hematology
• Biochemistry

Background:

• Iron is vital for oxygen transport and cellular metabolism.
• Iron deficiency (ID) can lead to serious health issues, particularly in older adults (OAs).
• Understanding iron compartments (functional, reserves, transferrin) is key to diagnosing ID.

Purpose of the Study:

• To provide an updated overview of iron metabolism and ID.
• To highlight the specific challenges and manifestations of ID in older adults.
• To emphasize the importance of accurate diagnosis for effective treatment.

Main Methods:

• Review of iron metabolism and ID pathophysiology.
• Analysis of biological markers for differentiating ID types.
• Focus on the unique aspects of ID in the elderly population.

Main Results:

• Two types of ID exist: absolute (low iron reserves, often due to bleeding) and functional (normal/high reserves, due to inflammation).
• Older adults have a high prevalence of ID (up to 20% in those ≥85 years), with severe consequences like cognitive impairment.
• Distinct biological profiles characterize absolute ID (low ferritin, low transferrin saturation, high sTfR) and functional ID (high ferritin, normal/low TS, normal sTfR).

Conclusions:

• Iron deficiency in older adults is frequent and can be multifactorial due to comorbidities.
• Accurate diagnosis of ID type using specific biological markers is essential for appropriate management.
• Timely diagnosis and treatment of ID in older adults can prevent severe health consequences.