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Anemia in older persons.
Am Fam Physician. 2010 Sep 01; 82(5):480-7.AF

Abstract

Anemia in older persons is commonly overlooked despite mounting evidence that low hemoglobin levels are a significant marker of physiologic decline. Using the World Health Organization definition of anemia (hemoglobin level less than 13 g per dL [130 g per L] in men and less than 12 g per dL [120 g per L] in women), more than 10 percent of persons older than 65 years are anemic. The prevalence increases with age, approaching 50 percent in chronically ill patients living in nursing homes. There is increasing evidence that even mild anemia is associated with increased morbidity and mortality. Anemia warrants evaluation in all older persons, except those at the end of life or who decline interventions. About one third of persons have anemia secondary to a nutritional deficiency, one third have anemia caused by chronic inflammation or chronic kidney disease, and one third have unexplained anemia. Nutritional anemia is effectively treated with vitamin or iron replacement. Iron deficiency anemia often is caused by gastrointestinal bleeding and requires further investigation in most patients. Anemia of chronic inflammation or chronic kidney disease may respond to treatment of the underlying disease and selective use of erythropoiesis-stimulating agents. The treatment of unexplained anemia is difficult, and there is little evidence that treatment decreases morbidity and mortality, or improves quality of life. Occasionally, anemia may be caused by less common but potentially treatable conditions, such as autoimmune hemolytic anemia, malignancy, or myelodysplastic syndrome.

Authors+Show Affiliations

University of Colorado Denver School of Medicine, Aurora, Colorado, USA. michael.bross@ucdenver.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20822082

Citation

Bross, Michael H., et al. "Anemia in Older Persons." American Family Physician, vol. 82, no. 5, 2010, pp. 480-7.
Bross MH, Soch K, Smith-Knuppel T. Anemia in older persons. Am Fam Physician. 2010;82(5):480-7.
Bross, M. H., Soch, K., & Smith-Knuppel, T. (2010). Anemia in older persons. American Family Physician, 82(5), 480-7.
Bross MH, Soch K, Smith-Knuppel T. Anemia in Older Persons. Am Fam Physician. 2010 Sep 1;82(5):480-7. PubMed PMID: 20822082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anemia in older persons. AU - Bross,Michael H, AU - Soch,Kathleen, AU - Smith-Knuppel,Teresa, PY - 2010/9/9/entrez PY - 2010/9/9/pubmed PY - 2010/9/30/medline SP - 480 EP - 7 JF - American family physician JO - Am Fam Physician VL - 82 IS - 5 N2 - Anemia in older persons is commonly overlooked despite mounting evidence that low hemoglobin levels are a significant marker of physiologic decline. Using the World Health Organization definition of anemia (hemoglobin level less than 13 g per dL [130 g per L] in men and less than 12 g per dL [120 g per L] in women), more than 10 percent of persons older than 65 years are anemic. The prevalence increases with age, approaching 50 percent in chronically ill patients living in nursing homes. There is increasing evidence that even mild anemia is associated with increased morbidity and mortality. Anemia warrants evaluation in all older persons, except those at the end of life or who decline interventions. About one third of persons have anemia secondary to a nutritional deficiency, one third have anemia caused by chronic inflammation or chronic kidney disease, and one third have unexplained anemia. Nutritional anemia is effectively treated with vitamin or iron replacement. Iron deficiency anemia often is caused by gastrointestinal bleeding and requires further investigation in most patients. Anemia of chronic inflammation or chronic kidney disease may respond to treatment of the underlying disease and selective use of erythropoiesis-stimulating agents. The treatment of unexplained anemia is difficult, and there is little evidence that treatment decreases morbidity and mortality, or improves quality of life. Occasionally, anemia may be caused by less common but potentially treatable conditions, such as autoimmune hemolytic anemia, malignancy, or myelodysplastic syndrome. SN - 1532-0650 UR - https://www.unboundmedicine.com/medline/citation/20822082/Anemia_in_older_persons_ DB - PRIME DP - Unbound Medicine ER -