Anemia in Elderly

Anemia in Elderly Linked to Declines
Even Mild Anemia Is a Risk Factor for Loss of Physical Function
By Salynn Boyles
WebMD Health News

July 25, 2003 -- Elderly people with anemia have twice the risk of experiencing physical declines that can end up robbing them of their independence, according to new research supported by the National Institute on Aging.

Wake Forest University researchers report for the first time that anemia is a major risk factor for age-related loss of physical function. Lead researcher Brenda Penninx, PhD, tells WebMD that the findings should help call attention to a condition that is underdiagnosed and undertreated in elderly populations.

"Although we didn't look at treatment in this study, the hope is that by correcting the anemia we can prevent some of the physical declines that we saw," she says. "That could keep older people out of nursing homes and hospitals."

Weakness, Irritability
Roughly 13% of people over the age of 70 are anemic, meaning that their capacity to carry oxygen in the blood is compromised. As a result, people with anemia often feel weak, tired, dizzy, or irritable. If not treated it can force the heart to work harder, leading to more serious consequences.

In elderly people, anemia can often be caused by an underlying disease such as cancer or kidney failure or by treatments for these diseases. Poor nutrition is a less common cause among the elderly, and no cause can be identified in about 30% of cases.

Penninx and colleagues followed a group of 1,146 people over the age of 70 for about four years, during which time they assessed physical abilities such as standing balance, walking, and the ability to rise from a chair. By the end of the study, two-thirds of the participants had experienced some declines and 30% experienced substantial declines.

People with borderline anemia were found to be at 1.5 times the risk of those who were not anemic. The findings are published in the August issue of The American Journal of Medicine.

"This study suggests that even mild anemia is a risk factor linked to reduced ability of older people to function at their fullest potential," National Institute of Aging epidemiologist Jack Guralnik, MD, PhD, says in a news release. "Further research will tell us whether the treatment of anemia can prevent the progressive decline in function that eventually results in disability."
The researchers also found that elderly people with anemia were associated with a 150% increase in hospitalization risk and a 200% increase in risk of being admitted to a nursing home.

Drugs Available to Treat Anemia
American Geriatrics Society spokesman Charles Cefalu, MD, MS, tells WebMD that the diagnosis of anemia among elderly patients has not been a priority in the past because there were no effective treatments for the condition. That changed, however, with the introduction of epoetin alfa, the first drug approved for the treatment of anemia.

The injectable drug is marketed under the brand names Epogen and Procrit. It is approved specifically for anemia related to treatments for kidney failure, HIV, and cancer.

"I think anemia among the elderly will get more attention because of studies like this one and because there is now something that we can do about it," Cefalu says. "We need studies to determine that these emerging treatments are effective for larger populations of anemic patients."


Possible Complications of Anemia in the Elderly
By Anne Ahira


There are many possible complications that may occur with Anemia in the elderly population. While it is true that most incidents of this condition are considered to be relatively mild, it is important to keep in mind that when a person suffers from Anemia, the basic transportation system of oxygen within the blood is affected.

Even mild cases of this condition may result in fatigue. In more serious cases of Anemia, the fatigue and low energy levels produced by the reduction in oxygen transport within the body may become crippling. There are many other complications that may be experienced by the elderly too.

Secondary Damage
When Anemia occurs, there is a drastic reduction in the red blood cells of the body. When this happens, the body's ability to absorb oxygen directly from the lungs is drastically hindered. As a result, it is common for the Anemia to result in basic dysfunction of the organs of the body.

Naturally, if an organ is not working properly, it results in direct damage of that organ. In the elderly, the organ most often affected by this secondary damage is the heart. In particular case studies, it has been found that the elderly over the age of eight five years have higher mortality rates than others that are younger.


Immediate Concerns
There are many immediate concerns when evaluating the possible complications of Anemia in older patients. The first, of course, is the effect that the condition has on the heart. It has been discovered that the condition increases a person's risk of developing a condition that is cardiac based. If a person does experience a complication that is cardiac related, such as a heart attack or failure of the heart, the survival rate is drastically decreased if they suffer from Anemia.

In addition to this, Anemia has been linked to the onset of a form of dementia that is referred to as "Vascular". If you or someone that you know is considered to be elderly, it is essential to work closely with a medical professional on a treatment plan to resolve any type of Anemia that may be experienced.


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