$16 million grant supports study of unexplained anemia in older adults

February 18, 2010

A $16 million grant from the National Institute on Aging will enable a team of national experts to study why unexplained anemia is so common in older adults and find better treatments. The Partnership for Anemia: Clinical and Translational Trials in the Elderly brings together specialists from seven leading centers to study older adults with unexplained anemia and to use the knowledge gained to develop improved therapies.

"The health implications of unexplained anemia are considerable," said hematologist Andrew Artz, MD, MS, assistant professor of medicine at the University of Chicago, director of the geriatric anemia clinic at the Medical Center and co-principal investigator for the partnership. "Anemia in the elderly has been linked to decreased quality of life, impaired cognition, greater hospitalization, and even a greater risk of death and it is three times more common in African-Americans."

Anemia affects about 11 percent of adults over the age of 65. That rises to 20 percent of those over 85 years who live independently, and nearly 50 percent of those who are hospitalized or institutionalized. Two-thirds of those cases can be attributed to nutritional deficiencies or an underlying medical condition like kidney disease. For the rest, the cause is unknown.

Older patients with anemia have been a difficult group to study, according to team leader Harvey J. Cohen, MD, director of the Center for the Study of Aging at Duke University Medical Center. "Anemia has been underappreciated as a potential cause for adverse effects and it has been challenging to enroll patients in clinical trials. Physicians are sometimes reluctant to refer older people, patients may not be interested in traveling to centers where trials are conducted, or this age cohort may fear they are being 'experimented on.'"

Anemia management has been complicated by several recent trials that produced "rather unexpected results," said Lynda Szczech, MD at the Duke Clinical Research Institute where consortium operations will be coordinated. "This consortium is poised to address these results and understand the impact of correcting anemia in a truly vulnerable population."

The first of several planned trials is expected to start accruing patients around September of 2010. "A major focus of all trials will be to determine whether anemia correction leads to improved function in older patients," Artz said.

"The government has challenged us to lay the groundwork for what's needed," Cohen said. "By bringing together the best minds in geriatrics, hematology, and nephrology, we hope to shed light on the causes of unexplained anemia and translate that knowledge into better treatments."

Additional consortium members include Stan Schrier and Elizabeth Price of Stanford University, Huiman Barnart of Duke, David Reuben of UCLA, Nathan Berger of Case Western Reserve University, Jeremy Walston of Johns Hopkins University, Victor Gordeuk of Howard University, Neeraj Agarwal and Josef Prchal of the University of Utah, and NIA representatives.