Identification and treatment of anaemia in older patients

Extract

Anaemia is the most common haematological problem of older patients. Given the heterogenous nature of this group, with an age span of over 30 years, the reported prevalence of anaemia is, not surprisingly, quite variable. However, a large survey from the UK has reported an overall prevalence of anaemia of 20.1% in elderly men and 13.7% in elderly women.

The types and causes of anaemia differ between elderly and younger patients. Anaemia of chronic disease becomes the commonest cause of anaemia in the older age group and reflects the increased incidence of chronic inflammation and malignancy in later years. Iron deficiency anaemia is commonly seen and due to gastrointestinal blood loss. Furthermore dietary deficiencies not only of iron, but also of folate, protein and ascorbic acid can all precipitate anaemia in the many elderly subjects who live in poor socio-economic conditions. Pernicious anaemia, as with other autoimmune conditions, is also encountered more commonly in the elderly than in the younger population. Malignant blood disorders with associated anaemia, such as myelodysplasia and leukaemia, become more frequent with advancing age.