Abstract
BACKGROUND: Previous investigations showed that the prevalence of iron deficiency is increasing in United States (US). However, data regarding iron deficiency anemia-related mortality trends are lacking. We assess the trends in iron deficiency anemia-related mortality in US adults aged 65 years or older over the last two decades. METHODS: Iron-deficiency anemia-related deaths were ascertained using ICD-10 codes in the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2019. Age-adjusted mortality rates (AAMRs) were assessed using the Joinpoint regression modelling and expressed as estimated average annual percentage change (AAPC) and annual percent change (APC) with relative 95% confidence interval (95% CI), stratified by level of urbanization, sex, age, and race. RESULTS: Between 1999 and 2019, 30,540 US subjects aged ≥ 65 years old (11,986 men and 18,554 women) equating to 77.8 deaths per 100,000 or 27.9 deaths per week, had iron deficiency anemia listed as a cause of death. The AAMR remained stable from 1999 to 2013 [APC: -0.3, (95%CI: -0.9 to 0.1, p = 0.11)] and then sharply increased from 2013 to 2019 [APC: +9.7% (95%CI: 7.8 to 11.6), p < 0.0001) without differences in sex, race, ethnicity or level of urbanization. The higher AAMRs were clustered in the Midwest [4.29 per 100,000 (95% CI: 4.20 to 4.38)] and in the South [3.35 per 100,000, 95% CI: 3.28 to 3.35)]. CONCLUSIONS: Over the last two decades the iron deficiency anemia-related mortality trends increased among US older subjects, without differences by sex, race, ethnicity or urbanicity.