The Anaemias

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk
Reference work entry


Haemopoietic stem cells (HSCs) are responsible for the production and replenishment of major lineages of blood and immune cells throughout life. There is an age-related decline in haemoglobin from age 70 to 88 among healthy men and less marked in women. This review discusses the pathogenesis of the anaemias and their clinical manifestations and presents an algorithm for their evaluation and management. Anaemias may result from blood loss, inadequate red cell production and excessive red cell destruction. The review provides an overview of the common types of anaemias in the elderly, the iron deficiency anaemia, anaemia of chronic disease and vitamin B12 and folic acid deficiencies and their mechanisms and clinical management. An elderly presenting with iron deficiency is almost exclusively due to blood loss from the gastrointestinal tract. A wide variety of iron preparations are available. Parenteral iron therapy is safe and effective in iron deficiency anaemia. Anaemia of chronic disease (ACD) also referred to as anaemia of chronic inflammation (ACI) is the most common form of anaemia in the elderly, and several diseases (acute and chronic infections, inflammatory disorders and neoplasms) are associated with ACD. Many old people suffer from a deficiency of vitamin B12 (cobalamin). Many neurological and psychiatric symptoms may occur, alone or in association with the haematological abnormalities, and may be present in the absence of anaemia.


Haemopoietic stem cells Iron deficiency anaemia Anaemia of chronic disease Vitamin B12 deficiency 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 1
  • Gary Cheuk
    • 2
  1. 1.The University of SydneyWestmead Clinical SchoolWestmeadAustralia
  2. 2.Rehabilitation and Aged Care ServiceBlacktown-Mt Druitt HospitalMount DruittAustralia

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