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. Author manuscript; available in PMC: 2009 Oct 1.
Published in final edited form as: Semin Hematol. 2008 Oct;45(4):250–254. doi: 10.1053/j.seminhematol.2008.06.003

Table 3.

Component Factors of Unexplained Anemia: Aging Versus Disease

Aging Disease
Erythropoietin insufficiency There is an age-associated decline in GFR and presumably a corresponding reduction in erythropoietin response. Diabetes, hypertension, and chronic inflammation have been associated with reduction in erythropoietin response and anemia.
Cytokine inhibition of erythropoiesis Certain proinflammatory cytokines, most notably IL-6, are elevated in serum and tissue sections with advancing age. Inflammatory diseases, including atherosclerosis and cancer, are associated with the presence of increased pro-inflammatory cytokines.
Androgen decline (both males and females) Androgens support erythropoiesis and declining levels with advancing age. Certain diseases are associated with decline in testosterone. Furthermore, anti-androgen therapy as treatment for prostate cancer is associated with a drop in hemoglobin of 1 g/dL.
Stem cell function Hematopoietic stem cells decline in both replicative and proliferative capacity with age. Certain diseases and/or treatments will inhibit the proliferative capacity of stem cells.
Myelodysplasia A disease process and NOT a component of normal aging. To the extent that it may present with anemia (without the other features such as neutropenia or thrombocytopenia) it will account for some component of UA.