Causes of iron deficiency anemia in elderly
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Causes of Iron Deficiency Anemia in the Elderly
Prevalence and Impact of Iron Deficiency Anemia in the Elderly
Iron deficiency anemia (IDA) is a prevalent condition among the elderly, significantly impacting their health and quality of life. Studies indicate that anemia affects approximately 20.1% of elderly men and 13.7% of elderly women in the UK 4. The condition is associated with increased morbidity and mortality, leading to a decline in physical performance, higher risk of falls, and depression 12.
Dietary Inadequacies and Nutritional Deficiencies
One of the primary causes of IDA in the elderly is inadequate dietary intake. As people age, their dietary habits often change, leading to insufficient iron consumption. This can be exacerbated by poor absorption of nutrients due to age-related changes in the gastrointestinal tract 17. Additionally, deficiencies in other nutrients such as vitamin B12 and folate are common and can contribute to anemia 37.
Chronic Inflammation and Disease
Chronic inflammation is another significant factor contributing to IDA in the elderly. Inflammatory diseases can interfere with iron metabolism, leading to functional iron deficiency where iron is present but not adequately utilized by the body 29. Elevated levels of inflammatory markers such as C-reactive protein are often correlated with lower hemoglobin levels in anemic patients 2.
Gastrointestinal Blood Loss
Gastrointestinal (GI) blood loss is a major cause of iron deficiency in older adults. Conditions such as peptic ulcers, colorectal cancer, and other GI lesions can lead to chronic blood loss, depleting the body's iron stores 89. Studies have shown that a significant proportion of elderly patients with IDA have positive fecal occult blood tests or identifiable lesions on endoscopy 9.
Renal Insufficiency
Renal insufficiency is also a common contributor to anemia in the elderly. Reduced kidney function can lead to decreased production of erythropoietin, a hormone essential for red blood cell production, thereby contributing to anemia 25. This condition is often observed in conjunction with other factors such as chronic inflammation and iron deficiency.
Myelodysplastic Syndromes and Hematologic Malignancies
A subset of elderly patients with anemia may have underlying hematologic conditions such as myelodysplastic syndromes (MDS) or other malignancies. These conditions can impair the bone marrow's ability to produce healthy blood cells, leading to anemia 5. In some studies, up to 21% of elderly patients with anemia were found to have a hematologic malignancy or were suspected of having MDS 5.
Diagnostic Challenges and Management
Diagnosing IDA in the elderly can be challenging due to the multifactorial nature of the condition and the presence of comorbidities. Serum ferritin is a useful test for differentiating iron deficiency anemia from anemia of chronic disease, but it may not always be definitive 36. Comprehensive evaluations, including blood tests, bone marrow examinations, and GI endoscopies, are often necessary to identify the underlying causes 9.
Conclusion
Iron deficiency anemia in the elderly is a complex condition with multiple contributing factors, including dietary inadequacies, chronic inflammation, gastrointestinal blood loss, renal insufficiency, and hematologic malignancies. Effective management requires a thorough diagnostic approach to identify and address the underlying causes, ensuring appropriate treatment and improving the quality of life for affected individuals.
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Iron status in the elderly
Iron-deficiency anaemia in the elderly is common and leads to decline in physical performance, increased risk of falling, and depression, but high dose iron supplements may have adverse effects.
Highly CitedPrevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort
Anemia is common in elderly patients, with multifactorial causes including chronic inflammation, functional iron deficiency, and renal impairment, and potential undiagnosed myelodysplastic syndromes.
Observational Study
Rigorous JournalHighly CitedAnemia in the elderly.
Anemia in the elderly can be effectively treated with oral vitamin B12 and folate supplements, and gastrointestinal bleeding can be effectively treated with oral antacids.
Highly CitedIron deficiency anaemia in older people: investigation, management and treatment.
Iron deficiency anaemia is common in older people and should be investigated and treated, as it can lead to increased mortality and contribute to chronic disease.
Iron Deficiency Is a Common Cause of Anemia in Elderly Outpatients, However Iron Repletion Frequently Does Not Fully Correct the Anemia.
Iron deficiency is a common cause of anemia in elderly outpatients, but iron repletion often does not fully correct the anemia, and a comprehensive hematologic evaluation is crucial for accurate diagnosis and treatment.
Observational StudyIron Deficiency Anemia.
Iron deficiency is a common cause of anemia, with symptoms including fatigue, hair loss, and restless legs.
Highly CitedCauses of Anemia in Polish Older Population—Results from the PolSenior Study
Age-specific criteria for nutrient deficiency diagnosis are necessary for identifying anemia in elderly populations, as current WHO criteria may overestimate or underestimate deficiency prevalence.
Observational StudyMolecular Aspects and Treatment of Iron Deficiency in the Elderly
Iron deficiency in the elderly is a common disorder, but it should not be considered a normal ageing consequence; diagnosis and treatment should be influenced by severity, underlying conditions, and patient clinical state.
Evaluation of Iron Deficiency Anemia in Elderly
Iron deficiency anemia in elderly patients is often caused by chronic gastrointestinal blood loss, and may be associated with gastrointestinal malignancies.
Observational StudyThe roles of inflammation and iron deficiency as causes of anemia.
Inflammatory disease and iron deficiency contribute to anemia, with iron deficiency being more common in children and young women and inflammation in elderly individuals.
Observational StudyHighly Cited