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To the Editor: Although the study by Dr Izaks and colleagues¹ on the definition of anemia in older persons provides valuable information, several key points require clarification.

First, all the statistically significant mortality data presented are for the 0- to 5-year follow-up period. For the remaining 5- to 10-year follow-up period, however, there is no difference in mortality between anemic and normocythemic patients. In fact, in patients without apparent clinical disease, there is a trend toward a decreased risk of death in anemic patients. Can the authors explain this? In addition, was the difference in the mortality rate between anemic and normocythemic patients statistically significant?

Second, the authors state that " . . . further clinical investigation is warranted if an older person's hemoglobin concentration is below the WHO [World Health Organization] normal values [<7.5 mmol/L (120 g/L) in women and <8.1 mmol/L (130 g/L) in men]—even if the person . . . [Full Text of this Article]

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RELATED ARTICLE

The Definition of Anemia in Older Persons
Gerbrand J. Izaks, Rudi G. J. Westendorp, and Dick L. Knook
JAMA. 1999;281(18):1714-1717.
ABSTRACT | FULL TEXT