Characteristics of Anemia in Elderly: A Hospital Based Study in South India

Original Article

Abstract

Anemia is a common concern in older people and can have significant morbidity and mortality. Because anemia is a sign, not a diagnosis, an evaluation is almost always warranted to identify the underlying cause. The purpose of this study was to study the clinical profile of elderly patients with anemia and to study characteristics of hematological types of anemia in such patients as well as the closest possible etiological profile. Hundred patients above the age of 60 years were included in the study. Clinical profile with laboratory studies of Hemoglobin and diagnostic tests to fix the etiology. Majority of patients had normocytic blood picture. Renal failure was the most common underlying chronic disease. Significant number of patients were on non steroidal anti-inflammatory drugs which could contribute to the anaemia. 14% of the patients had an underlying malignancy. 73.3% of the patients in the microcytic group had an underlying GI lesion on endoscopy. Identifying anemia as an important aspect of a comprehensive geriatric assessment is absolutely essential further to clinical detection. Confirming the type of anemia is critical to direct the investigation for profiling the etiology since it is well known that the treatment of anemia goes a long way in improving the overall outcome and quality of life.

Keywords

Anemia Geriatric Fe deficiency Anemia of chronic disease Etiology 

References

  1. 1.
    Ania Lafuente BJ, Fernandez-Burriel Tercero M, Suarez Almenara JL, Betancort Mastrangelo CC, Guerra Hernandez L (2001) Anemia and functional capacity at admission in a geriatric home. An Med Interna 18(1):9–12PubMedGoogle Scholar
  2. 2.
    Salive ME, Cornoni-Huntley J, Guralnik JM et al (1992) Anemia and hemoglobin levels in older persons: relationship with age, gender, and health status. J Am Geriatr Soc 40:489–496PubMedGoogle Scholar
  3. 3.
    Ania BJ, Suman VJ, Fairbanks VF (1997) Incidence of anemia in older people: an epidemiologic study in a well defined population. J Am Geriatr Soc 45:825–831PubMedGoogle Scholar
  4. 4.
    Penninx BW, Guralnik JM, Onder G, Ferrucci L, Wallace RB, Pahor M (2003) Anemia and decline in physical performance among older persons. Am J Med 115:104–110CrossRefPubMedGoogle Scholar
  5. 5.
    World Health Organization. Definition of an older or elderly person. http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html. Retrieved August 29, 2010
  6. 6.
    Mary Lynn R, Sutin D (2003) Blood disorders and their management in old age. In: Geriatric medicine and gerontology. Churchill Livingstone, Edinburg, pp 1229–1230Google Scholar
  7. 7.
    Davenport J (1996) Macrocytic anemia. Am Fam Physician 53(1):155–162PubMedGoogle Scholar
  8. 8.
    Varat M, Adolph R, Fowler N (1972) Cardiovascular effects of anemia. Am Heart J 83:415–426CrossRefPubMedGoogle Scholar
  9. 9.
    Mehta BC (1999) Iron deficiency anemia. In: Shah S, Anand M (eds) API textbook of medicine, 6th edn. Association of Physicians of India, MumbaiGoogle Scholar
  10. 10.
    Joosten E, Pelemans W, Hiele M (1992) Prevalence and causes of anemia in a geriatric hospitalized population. Gerontology 38:111–117CrossRefPubMedGoogle Scholar
  11. 11.
    Elis A, Ravid M, Manor Y, Bental T, Lishner M (1996) A clinical approach to idiopathic normocytic–normochromic anemia. J Am Geriatr Soc 44:832–834PubMedGoogle Scholar
  12. 12.
    Milman N, Schultz-Larsen K (1994) Iron stores in 70 year old Danish men and women. Ageing 6(2):97–103Google Scholar
  13. 13.
    Chaves PHM, Ashar B, Guralnik JM, Fried LP (2002) Looking at relationship between hemoglobin concentration and prevalent mobility difficulty in older women. J Am Geriatr Soc 50(7):1257–1264CrossRefPubMedGoogle Scholar
  14. 14.
    Metz JA (2008) High prevalence of biochemical evidence of vitamin B12 or folate deficiency does not translate into a comparable prevalence of anemia. Food Nutr Bull 29(2 Suppl):S74–S85PubMedGoogle Scholar
  15. 15.
    Keller CR, Odden MC, Fried LF, Newman AB, Angleman S, Green CA et al (2007) Kidney function and markers of inflammation in elderly persons without chronic kidney disease: the health, aging, and body composition study. Kidney Int 71:239–244CrossRefPubMedGoogle Scholar
  16. 16.
    Elejalde Guerra JI, Alonso Martinez JL, Rubio Vela T, Garcia Labairu C, Llorente B, Echegaray M (1999) Etiological study and diagnosis of anemia in adults over 60 years of age. Sangre 44(6):418–423PubMedGoogle Scholar
  17. 17.
    Sumner AE, Chin MM, Abraham JL, Berry GT, Gracely EJ, Allen RH et al (1996) Elevated methylmalonic acid and total homocysteine levels show high prevalence of vitamin B12 deficiency surgery. Ann Intern Med 124:469–476PubMedGoogle Scholar
  18. 18.
    Chernetsky A, Sofer O, Rafael C, Ben-Israel J (2002). Prevalence and etiology of anemia in an institutionalized geriatric population. Harefuah 141(7):591–594, 667Google Scholar
  19. 19.
    Stabler SP (1998) Vitamin B12 deficiency in older people: improving diagnosis and preventing disability [Editorial]. J Am Geriatr Soc 46:1317–1319PubMedGoogle Scholar
  20. 20.
    Seward SJ, Safran C, Marton KI, Robinson SH (1990) Does the mean corpuscular volume help physicians evaluate hospitalized patients with anemia? J Gen Intern Med 5:187–191CrossRefPubMedGoogle Scholar
  21. 21.
    Coban E, Timuragaoglu A, Meric M (2003) Iron deficiency anemia in the elderly: prevalence and endoscopic evaluation of the gastrointestinal tract in outpatients. Acta Haematol 110:25–28CrossRefPubMedGoogle Scholar
  22. 22.
    Rockey DC, Cello JP (1993) Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med 329:1691–1695CrossRefPubMedGoogle Scholar
  23. 23.
    Joosten E, Ghesquiere B, Linthoudt H, Krekelberghs F, Dejaeger E, Boonen S et al (1999) Upper and lower gastrointestinal evaluation of elderly inpatients who are iron deficient. Am J Med 107:24–29CrossRefPubMedGoogle Scholar
  24. 24.
    Rockey DC, Cello JP (1999) Evaluation of gastrointestinal tract in patients with iron deficiency anemia. N Engl J Med 329:1691–1695CrossRefGoogle Scholar
  25. 25.
    Carmel R (2001) Anemia and aging: an overview of clinical, diagnostic and biological issues. Blood Rev 15:9–18CrossRefPubMedGoogle Scholar
  26. 26.
    Beghe C, Wilson A, Ershler WB (2004) Prevalence and outcome of anemia in geriatrics: a systematic review of the literature. Am J Med 116(7):3–10CrossRefGoogle Scholar
  27. 27.
    Drewnowski A, Shultz JM (2001) Impact of aging on eating behaviors, food choices, nutrition, and health status. J Nutr Health Aging 5:75–79PubMedGoogle Scholar

Copyright information

© Indian Society of Haematology & Transfusion Medicine 2011

Authors and Affiliations

  1. 1.Department of MedicineM.S. Ramaiah Medical College and HospitalBangaloreIndia

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