Iron deficiency linked to fatigue, poor functional status in elderly hospitalized patients

Among elderly hospitalized patients, iron deficiency increases risk of fatigue and poor functional recovery, a recent study has found.

The researchers enrolled 224 eligible patients (aged 65–95 years; 67 percent women) admitted into a geriatric acute care ward. Serum ferritin, iron, and transferrin, along with blood haemoglobin, were measured, and current use of iron supplementation was also taken into account. All patients underwent geriatric assessment during admission.

Ninety-one participants (41 percent) had iron deficiency, defined as serum ferritin < 30 ng/L and transferrin saturation (TSAT) <16%. Baseline median scores in the fatigue severity scale were significantly higher among those with iron deficiency (5.2 vs 4.2; p<0.01); the same was true for the frail simple scale (4 s 3.5; p<0.05).

During hospital stay, both subgroups of patients with and without iron deficiency saw significant improvements in measures of functional status, including handgrip strength, isometric knee extension strength, and Barthel Index scores. While within-group changes were significant, between-group comparisons were not.

Fifty-one iron-deficient participants received supplementation during hospital stay, majority of whom (n=49; 96 percent) were given oral supplements; two needed intravenous iron. Those who had taken supplements had significantly better isometric knee extension strength at discharge than comparators without supplementation (19.1±7.8 vs 14.3±6.4 kg; p=0.005). No other parameter was affected.

Stepwise multiple regression analysis confirmed that iron deficiency was a significant and independent correlate of fatigue during admission (β, –0.534; p=0.019) and of changes in Barthel Index scores over the course of hospitalization (β, –3.917; p=0.034).