Thrombocytopenia in Older Adults

Abstract

Thrombocytopenia in older patients is associated with several characteristics that are often underrecognized. Among them are the risk of bleeding complications, the senescence of the bone marrow, the increased use of multiple drugs, and greater comorbidity. In this article, the various forms of thrombocytopenia, including primary and drug-associated immune thrombocytopenias, as well as other drug-associated thrombocytopenias, are reviewed. In addition, how age-related changes in platelet function may affect the bleeding risk is discussed.

Impact of severity of baseline thrombocytopenia on outcomes after percutaneous coronary interventions: Analysis from the Veterans Affairs Clinical Assessment, Reporting, and Tracking (VA CART) Program

“…Platelet counts decrease with age and relatively mild TCP is not uncommon among healthy older adults and often not considered pathological among healthy older adults (prevalence as high as 4%) 1 . The results of the current study suggest that even mild TCP increases the risk of long‐term mortality after PCI (after adjustment for age and other comorbidities) and may not be a benign finding in those with severe CAD.…”

“…Thrombocytopenia (TCP) is a common hematological defect that affects up to 4% of the general population and is increasing in incidence due to an aging population. 1 Platelets play an important role in the pathogenesis of acute coronary syndrome (ACS) and the presence of TCP has not been shown to protect against ACS. 2,3 Simultaneously, TCP can complicate percutaneous interventions (PCI) to treat coronary artery disease (CAD) due to an increased risk of bleeding.…”

Effects of sex, age, and season on the variation of blood analytes in a clinically healthyex situpopulation of bottlenose dolphins (Tursiopsspp.)

“…However, megakaryocytes are the precursor cells of platelets, and dolphins, unlike most other mammals, have megakaryocytes in both the bone marrow and spleen, a proposed physiological adaptation of diving mammals. 24 The decrease in platelet counts with age could be a normal sequela to this unique adaption and/or may reflect senescence of the bone marrow microenvironment 25 . Total protein progressively increased with age in all three populations.…”

Age-Related Changes in Thrombosis and Hemostasis

“…Older adults are also more often taking multiple drugs and are at higher risk for drug-induced thrombocytopenia. 11 Anticoagulants are more often used in older than in younger individuals and their administration poses a greater risk as well, as pointed out by Ko and Hylek. 12 Another important but often forgotten aspect in maintaining good health in aging is the quality of nutrition, ably reviewed by Dawson and Axford.…”