Anemia in the Elderly
By Lawrence Tim Goodnough, M.D.
Recent analyses of normal populations in the Third National Health and Nutrition Examination
Survey (NHANES III) reveal that anemia is an under-recognized problem, particularly in elderly people.
Overall, 11.0 percent of men and 10.29 percent of women 65 years and older are anemic. The implications
of this problem were discussed in a Meet-The-Expert session on Sunday morning led by Ralph Carmel,
M.D., from Cornell University.
One-third of the elderly who are anemic have nutritional causes: iron, folate, or B12 deficiency.
An additional third are identified as having chronic renal insufficiency, and the remaining third have
unexplained anemia. The magnitude of the problem of anemia in the elderly and its potential impact
on quality of life, recovery from illness, and functional abilities led the American Society of
Hematology to sponsor a research agenda-setting workshop for anemia and aging on March 1-2,
2004. Among issues reviewed, a research agenda was outlined to include: hemoglobin levels with
functional assessment along with accompanying comorbity; further insight into the causes of anemia,
particularly in the presence of accompanying chronic illness or disease; and the development of
clinical trials to determine whether anemia treatment can improve clinical outcomes, such as
functional independence.
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