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Journal of Gerontology and Geriatrics is published by MDPI from Volume 74 Issue 1 (2026). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Pacini Editore.
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Review

Iron Deficiency in the Elderly. Evidences from Different Clinical Settings and Efficacy of Iron Supplementation on Outcomes

by
Angela Sciacqua
1,
Giuseppe Armentaro
1,
Dario Leosco
2,*,
Giovambattista Desideri
3,
Andrea Ungar
4,
Edoardo Locatelli
5,6,
Stefano Volpato
5,6,
Irene Zucchini
7,8,
Marco Salvi
7,8,
Marcello Maggio
7,8,9,10,
Alba Malara
9,10 and
Rosanna Pullia
11
1
Geriatrics Division, University Hospital “R. Dulbecco”, University Magna Graecia of Catanzaro, Catanzaro, Italy
2
Department of Translational Medical Science, University of Naples “Federico II”, Naples, Italy
3
Department of Medical and Cardiovascular Sciences, Sapienza University of Rome and Division of Geriatric Care, Azienza Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
4
Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
5
Department of Medical Science, University of Ferrara, Ferrara, Italy)
6
Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
7
Geriatric Clinic Unit, University Hospital of Parma, Parma, Italy
8
Department of Medicine and Surgery, University of Parma, Parma, Italy
9
Fondazione ANASTE Humanitas, Roma, Italy
10
10 Centro Residenziale e di Riabilitazione San Domenico, Lamezia Terme (CZ), Italy
11
11 Scuola di Specializzazione in Geriatria, Università di Pisa, Pisa, Italy
 
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Author to whom correspondence should be addressed.
J. Gerontol. Geriatr. 2025, 73(4), 164-183; https://doi.org/10.36150/2499-6564-N932
Submission received: 2 December 2025 / Accepted: 7 January 2026 / Published: 15 January 2026
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Abstract

Iron deficiency (ID) is highly prevalent in older adults and remains frequently underdiagnosed despite its relevant prognostic impact. ID may be absolute or functional and is observed across multiple geriatric clinical settings, including heart failure, chronic kidney disease, malnutrition, fragility fractures and long-term care facilities. Beyond anaemia, ID contributes to impaired mitochondrial function, reduced exercise capacity, frailty, cognitive and functional decline, increased hospitalizations and mortality. In heart failure and CKD, ID – irrespective of haemoglobin – worsens clinical outcomes. Systematic assessment of iron status should be integrated into geriatric evaluation. Oral iron therapy is often limited by poor tolerance and hepcidin-mediated malabsorption, whereas intravenous formulations show greater efficacy in selected patients. Early identification and targeted correction of ID may improve symptoms, quality of life and functional recovery in elderly populations, although further large trials in very old and frail subjects are needed.
Keywords: iron deficiency older adults; anaemia; heart failure; chronic kidney disease iron deficiency older adults; anaemia; heart failure; chronic kidney disease

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MDPI and ACS Style

Sciacqua, A.; Armentaro, G.; Leosco, D.; Desideri, G.; Ungar, A.; Locatelli, E.; Volpato, S.; Zucchini, I.; Salvi, M.; Maggio, M.; et al. Iron Deficiency in the Elderly. Evidences from Different Clinical Settings and Efficacy of Iron Supplementation on Outcomes. J. Gerontol. Geriatr. 2025, 73, 164-183. https://doi.org/10.36150/2499-6564-N932

AMA Style

Sciacqua A, Armentaro G, Leosco D, Desideri G, Ungar A, Locatelli E, Volpato S, Zucchini I, Salvi M, Maggio M, et al. Iron Deficiency in the Elderly. Evidences from Different Clinical Settings and Efficacy of Iron Supplementation on Outcomes. Journal of Gerontology and Geriatrics. 2025; 73(4):164-183. https://doi.org/10.36150/2499-6564-N932

Chicago/Turabian Style

Sciacqua, Angela, Giuseppe Armentaro, Dario Leosco, Giovambattista Desideri, Andrea Ungar, Edoardo Locatelli, Stefano Volpato, Irene Zucchini, Marco Salvi, Marcello Maggio, and et al. 2025. "Iron Deficiency in the Elderly. Evidences from Different Clinical Settings and Efficacy of Iron Supplementation on Outcomes" Journal of Gerontology and Geriatrics 73, no. 4: 164-183. https://doi.org/10.36150/2499-6564-N932

APA Style

Sciacqua, A., Armentaro, G., Leosco, D., Desideri, G., Ungar, A., Locatelli, E., Volpato, S., Zucchini, I., Salvi, M., Maggio, M., Malara, A., & Pullia, R. (2025). Iron Deficiency in the Elderly. Evidences from Different Clinical Settings and Efficacy of Iron Supplementation on Outcomes. Journal of Gerontology and Geriatrics, 73(4), 164-183. https://doi.org/10.36150/2499-6564-N932

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