Anemia in an aging population.

1. Rebecca J Laudicina, PhD[⇑][1] 1. is professor, Clinical Laboratory Science, Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill NC 1. Address for Correspondence: Rebecca J Laudicina PhD, Division of Clinical Laboratory Science, 4110 Bondurant Hall, CB#7145, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7145. (919) 843-4350. Rebecca_Laudicina{at}med.unc.edu 1. State the World Health Organization criteria for defining anemia and discuss issues related to this definition. 2. Compare the prevalence of anemia in a variety of subgroups in persons over age 65. 3. Discuss the physical, cognitive, and economic impact of anemia in the elderly. 4. Characterize the major causes of anemia in the geriatric population. 5. Explain laboratory tests and results useful in identifying the cause of anemia in the elderly. Demographic data combined with the results of recent studies indicate that anemia is a significant health concern for our aging population. As of 2006, more than 37 million people in the United States are over age 65 with that number expected to reach 80 million by the year 2050.1,2 More than 10% of all individuals above age 65 have anemia. Furthermore, the prevalence of anemia increases with age, making our oldest seniors even more likely to develop anemia during their lifetimes.3 The significance of these facts led to a special symposium, “Anemia and the Elderly: A Public Health Crisis in Hematology”, conducted at the 2005 meeting of the American Society of Hematology.4 Although the presence of anemia may reflect an underlying or undetected medical condition, anemia is also an independent risk factor for morbidity and mortality in an array of disorders common to seniors, including cancer, renal disease, and heart disease.5 Furthermore, anemia affects physical and mental functioning and interferes with the ability to conduct activities of daily living, thus affecting quality of life. Because the elderly, defined by the US Census Bureau as persons over age 65, is the fastest growing segment of the US population, anemia may be projected to have an increasing impact on our healthcare system.2 In spite of these facts, anemia in elderly patients may be overlooked in medical evaluations due to similarity of symptoms with other disorders and lack of awareness of its prevalence. Diagnosis of anemia and determination of its cause are highly… ABBREVIATIONS: ACD = anemia of chronic disease; CBC = complete blood count; CHr = reticulocyte hemoglobin; EPO = erythropoietin; HGB = hemoglobin; HCT = hematocrit; IDA = iron deficiency anemia; MA = megaloblastic anemia; MCV = mean cell volume; MCH = mean cell hemoglobin; MCHC = mean cell hemoglobin concentration; RDW = red cell distribution width; RET = reticulocyte count; SI = serum iron; sTR = serum transferrin receptor;TIBC = total iron binding capacity; TS = transferrin saturation. 1. State the World Health Organization criteria for defining anemia and discuss issues related to this definition. 2. Compare the prevalence of anemia in a variety of subgroups in persons over age 65. 3. Discuss the physical, cognitive, and economic impact of anemia in the elderly. 4. Characterize the major causes of anemia in the geriatric population. 5. Explain laboratory tests and results useful in identifying the cause of anemia in the elderly. [1]: #corresp-1