Age ≥ 65 years old Hemoglobin concentration ≥ 9.0 g/dL and < 11.5 g/dL for women and ≥ 9.0 to < 12.7 g/dL for men Unexplained anemia (see Table 2 for identifiable etiologies of anemia that investigator must review) Serum ferritin level ≥ 20 and ≤ 200 ng/mL Able to walk without the use of a walker or motorized device, or the assistance of another person Able to understand and be willing to provide written informed consent in the absence of dementia, defined as a Montreal Cognitive Assessment score ≥ 22 Able to understand and speak in English, or at select sites where Spanish-speaking study staff and written informed consent in Spanish are available and approved by the institutional review board, Spanish- speaking subjects who do not speak English may be enrolled
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Red blood cell transfusions in the past 3 months Use of erythropoiesis stimulating agent in the past 3 months Intravenous iron infusions in the past 3 months Distance on baseline 6-minute walk test above age- and sex-adjusted population median History of unstable angina or myocardial infarction in the past 3 months History of stroke or transient ischemic attacks in the past 3 months Uncontrolled hypertension defined as greater than the average diastolic blood pressure > 100 mm Hg or systolic blood pressure > 160 mm Hg on 2 separate occasions on 2 separate days during screening Positive fecal occult blood test within the screening period Elevated aspartate aminotransferase or alanine aminotransferase ≥ 2× upper limit of normal Documented anaphylactic reaction to iron sucrose infusion in the past Initiated on oral iron supplementation within the last 6 weeks, or within the last 3 months and having had at least a 1 g/dL improvement in hemoglobin since starting oral iron supplementation
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