The prevalence of anemia in elderly patients: a cross-sectional study

Year 2022, Volume: 5 Issue: 2, 440 - 444, 15.03.2022

Jale Yıldız , Orkun Sarıçam

https://doi.org/10.32322/jhsm.1054184

Abstract

Introduction: As the elderly population continues to increase, physiological changes and pathological conditions in old age have started to attract more attention. Anemia is a common public health problem in both developed and developing countries. Many studies have emphasized the negative effects of anemia on poor physical performance, susceptibility to falls, impaired cognitive function and death in the elderly. Considering the classification of anemia, a substantial amount of unexplained anemia in the elderly population raises the question of whether this is a natural consequence of aging. Our aim in this study is to reveal the frequency of anemia in the geriatric population and to classification.
Material and Method: This retrospective cohort study was conducted with the evaluation of patients admitted to the internal medicine outpatient clinic of a secondary state hospital in Ankara. All patients over the age of 65 who applied to the internal medicine outpatient clinic with different complaints between December 2020 and September 2021 and had a hemogram test were evaluated for eligibility for the study.
Results: Anemia was present in 103 of 1210 patients over 65 years of age included in our study. In our study group, the frequency of anemia was 8.5%. The median age of patients with anemia was 73 (65-93) years, and 60.1% (n=62) of these patients were women. The number of patients with at least one comorbidity was 74 (71.8%). The most common type of anemia in patients with anemia was iron deficiency anemia (n=47, 45.6%). Anemia of chronic disease (n=16, 15.5%) was the second most common anemia, and anemia due to vitamin b12 deficiency (n=4, 3.8%) and folic acid deficiency (n=3, 2.9%) was less common. The rate of unexplained anemia was 27.2% (n=28).
Conclusion: It was revealed in our study that anemia is a common health problem in elderly patients in our society, and that unexplained anemia can be seen at a substantial rate. The prevalence of anemia of approximately 10% in our study gives the message that anemia is an important public health problem for the elderly population and that health care providers should be careful in terms of preventive and therapeutic measures.

Keywords

Anemia, elderly, unexplained anemia

References

• Orimo H, Ito H, Suzuki T, Araki A, Hosoi T, Sawabe M. Reviewing the definition of “elderly.” Geriatr Gerontol Int 2006; 6: 149-58.
• World Health Organization (WHO), https://www.who.int/ageing/publications/global_health.pdf, October 2011.
• Türkiye İstatistik Kurumu (TUIK), https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2020-37227, 18 March 2021.
• Bilir N. Yaşlılık tanımı, yaşlılık kavramı, epidemiyolojik özellikler. yaşlılık ve solunum hastalıkları: TÜSAD Eğitim Kitapları Serisi; 2018: 13-31.
• Penninx BW, Pluijm SM, Lips P, et al. Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc 2005; 53: 2106-11.
• Chaves PH, Carlson MC, Ferrucci L, Guralnik JM, Semba R, Fried LP. Association between mild anemia and executive function impairment in community-dwelling older women: The Women's Health and Aging Study II. J Am Geriatr Soc 2006; 54: 1429-35.
• Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med 2006; 119: 327-34.
• Penninx BW, Pahor M, Cesari M, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc 2004; 52: 719-24. 
• Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004; 104: 2263-68.
• Bach V, Schruckmayer G, Sam I, Kemmler G, Stauder R. Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Clin Interv Aging 2014; 9: 1187-96. 
• Camaschella C. Iron deficiency. Blood 2019; 133: 30–9.
• Oymak Y, İlhan G. B12 vitamin eksikliği tanı ve tedavi klavuzu. Eritrosit hastalıkları ve hemogoblobin bozuklukları tanı ve tedavi klavuzu, Türk Hematoloi Derneği 2019: 1-10.
• Devalia V, Hamilton MS, Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol 2014; 166: 496-513.
• Paula G. Fraenkel; Understanding anemia of chronic disease. Hematology Am Soc Hematol Educ Program 2015; 2015: 14–8.
• Penninx BWJH, Pahor M, Woodman RC, Guralnik JM. Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci 2006; 61: 474-9.
• Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR. Impact of anemia on hospitalization and mortality in older adults. Blood 2006; 107: 3841-6.
• Zakai NA, Katz R, Hirsch C, et al. A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med 2005; 165: 2214-20.
• Beghé C, Wilson A, Ershler WB. Prevalence and outcomes of anemia in geriatrics: a systematic review of the literature. Am J Med 2004; 116: 3S-10S.
• Anía BJ, Suman VJ, Fairbanks VF, Rademacher DM, Melton LJ. Incidence of anemia in older people: an epidemiologic study in a well defined population. J Am Geriatr Soc 1997; 45: 825-31.
• Artz AS, Thirman MJ. Unexplained anemia predominates despite an intensive evaluation in a racially diverse cohort of older adults from a referral anemia clinic. J Gerontol A Biol Sci Med Sci 2011; 66: 925-32.
• Tettamanti M, Lucca U, Gandini F, et al. Prevalence, incidence and types of mild anemia in the elderly: the "Health and Anemia" population-based study. Haematologica 2010; 95: 1849-56.
• Bach V, Schruckmayer G, Sam I, Kemmler G, Stauder R. Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Clin Interv Aging. 2014; 9: 1187-96. 
• Michalak SS, Rupa-Matysek J, Hus I, Gil L. Unexplained anemia in the elderly - a real life analysis of 981 patients. Arch Med Sci 2019; 16: 834-41.
• Taşar PT, Şahin S, Emgin Ö, et al. Evaluation of anemia in geriatric inpatients. Tepecik Eğit Hast Derg 2015; 25: 43-8.
• Yildirim T, Yalcin A, Atmis V, et al. The prevalence of anemia, iron, vitamin B12, and folic acid deficiencies in community dwelling elderly in Ankara, Turkey. Arch Gerontol Geriatr 2015; 60: 344-8.