Anemia in Individuals over Age 80: Unattended Issue in Clinical Practice

Abstract

Original Article Ewha Med J 2016;39(3):69-75 http://dx. Objectives:To assess the current state of anemia evaluation in the elderly over 80 years of age. Methods: Patients who were more than 80 years old and visited Dongguk University Ilsan Hospital from April 2005 to February 2014 were included. Statistical analysis were assessed using the logistic regression model. Results: Total 548 patients, who had anemia according to WHO criteria, were identified. The median age was 85 years old (range, 82 to 99 years) and median hemoglobin level was 11.0 g/dL (range, 2.7 to 12.9 g/dL). Twenty-eight, 468, and 52 patients were classified as microcytic anemia, normocytic anemia, and macrocytic anemia, respectively. Among them, 397 patients (72.4%) did not undergo proper evaluation for the cause anemia i.e., 8 cases (28.5%) of microcytic anemia, 361 cases (77.1%) of normocytic anemia, and the 28 cases (53.84%) of 52 macrocytic anemia patients. The remaining 151 patients (27.6%) had completed the evaluation, and 24 patients (15.9%) were diagnosed as solid malignancies. In the assessment of iron deficiency anemia, hemoglobin levels, and age had no effect on whether or not to perform esophagogastroduodenoscopy. Conclusion: This finding showed that physicians often neglected anemia in individuals over 80 years of age. Though these patients have limited life expectancy, physicians should carefully discriminate the sub-population who will be benefit from adequate evaluation and treatment. (Ewha Med J 2016;39(3):69-75)

High Anemia Prevalence in Korean Older Adults, an Advent Healthcare Problem: 2007-2016 KNHANES

“…Han et al [8] analyzed healthy individuals who underwent routine medical checkup in a single center and showed that mild anemia, de ned as having a hemoglobin level between 10.0 g/dL and 12.9 g/dL in men and 10.0 g/dL and 11.9 g/dL in women, is a risk factor for cancer and cardiovascular death in the elderly population. Jeong et al [24] also showed a high incidence of anemia in the population aged 80 years and more, and most of them were anemic from unknown reasons, which was closely related to malignancy as analyzed by routine medical checkup of laboratory data. These studies are small community-based cross-sectional studies within a selected population and are limited in re ecting the general Korean population.…”

High Anemia Prevalence in Korean Older Adults, an Urgent Healthcare Problem: 2007-2016 KNHANES

“…Reference values represent average levels with standard deviations, and the low hemoglobin levels in the older population might be considered as the standard reference values for this population group. Some reports concluded that this decrease in hemoglobin levels might be one of the consequences of the normal aging process; hence, the criteria for anemia should be different in this population [17,[22][23][24][25].…”

“…In this study, the prevalence of anemia ranged from 12% to 17%. These differences might be attributed to the diversity of the subjects and cohorts [3,8,23,25,28]. Studies conducted in nursing home-and hospital-based populations have shown signi cantly higher prevalence of anemia and morbidity.…”

High Anemia Prevalence in Korean Older Adults, an Urgent Healthcare Problem: 2007-2016 KNHANES

“…Reference values represent average levels with standard deviations, and the low hemoglobin levels in the older population might be considered as the standard reference values for this population group. Some reports concluded that this decrease in hemoglobin levels might be one of the consequences of the normal aging process; hence, the criteria for anemia should be different in this population [17,[22][23][24][25]. However, many reports also showed that anemia in older persons is related to the presence of underlying health conditions and is therefore associated with high mortality and morbidity.…”

“…In this study, the prevalence of anemia ranged from 12% to 17%. These differences might be attributed to the diversity of the subjects and cohorts [3,8,23,25,28]. Studies conducted in nursing home-and hospital-based populations have shown significantly higher prevalence of anemia and morbidity.…”