Anemia in the Elderly Population

Abstract

Anemia is a clinical condition whose incidence increases with age. It represents a severe risk factor with adverse outcomes, including hospitalization and mortality. In population-based studies, the incidence of anemia in the elderly was found to be 16.8% in women and 17.5% in men, but 30.7% in men of 85 years and older. The aim of the study was to identify the most important factors responsible for the incidence of anemia in the elderly. Pubmed was used, and we searched for the most important epidemiological and clinical studies conducted over last 10 years on anemia in the elderly population. After a comprehensive and standardized evaluation, only studies that accurately determined the causes of anemia and their proportion in older adults were considered. Anemia has been classified into three major classes: nutrient deficiencies, chronic disease or inflammation, and unexplained anemia. Malnutrition is a frequent, underevaluated clinical condition, including iron, folate or B₁₂ deficiencies, and accounts for one-third of all anemia in the elderly. The anemia of chronic disease (ACD) develops specifically in patients suffering from chronic inflammatory diseases, such as auto-immune disorders, cancer or chronic infections, or in patients undergoing dialysis. In ACD, cytokines and macrophages play a fundamental role. Unexplained anemia (UA) is the most relevant group, due to the reduction of hypoxia/erythropoietin-sensing mechanisms, oxidative stress, sarcopenia, and sex hormone reduction accounting for more than one-third of all anemia. The correct diagnosis allows physicians to perform the best therapeutic strategies that include energy, protein diet, and iron supplementation, erythropoietin, androgen administration and blood transfusion.




J Hematol. 2014;3(4):95-106
doi: http://dx.doi.org/10.14740/jh182w