Anaemia in older persons.

• Does old age cause anaemia? The answer is NO!!

• Anaemia is not normal in the elderly, but is a common problem.

• Anaemia in older persons is a serious problem.

• Anaemia means that the “red blood cell count”, or the level of the protein haemoglobin in red cells which carries oxygen through the body, is lower than normal which commonly results in adverse symptoms in the elderly.

• Anaemia usually indicates that the person is unwell and may reflect serious underlying diseases. 

• In those aged 85 and older the prevalence of anaemia exceeds 20% and in those elderly in Residential Aged Care settings such as hostels and nursing homes, the prevalence of anaemia can be above 60%. 

• Anaemia is commonly ignored, underdiagnosed and undertreated in the elderly!

• Anaemia in the elderly is associated with significant functional impairments in day-to-day living including-

  ·       Worsening breathlessness on minimal effort.

  ·       Chest pain.

  ·       Worsening heart failure.

  ·       Worsening kidney failure.

  ·       Dizziness.

  ·       Falls.

  ·       Confusion.

  ·       Depression.

  ·       General functional decline.

  ·       Reduced exercise tolerance/distance walked.

  ·       Increased risk for hospital Emergency Department presentation.

  ·       Longer length of hospital stay.

  ·       Increased mortality (death rate is doubled).

• Anaemia can contribute to delirium and worsen dementia. 

• Pre-operative anaemia before the elderly have major surgery is also associated with an increased complication rate after surgery including increased rates of post-operative infections.

• Anaemia should never be regarded as a normal part of ageing.  It is always caused by underlying illness and may be multi-factorial in nature.

• Even mild anaemia is common with haemoglobin less than the normal 13g/dl for males and less than 12g/dl for females.  This can cause significant problems for the elderly.

• Older frail people are poorly tolerant of severe anaemia and should be treated and transfused early.

• Anaemia should be actively investigated, diagnosed and managed, as older people can suffer significant symptoms and impairment of day-to-day function with even mild anaemia.

• They can have dramatic symptomatic, functional improvement and much better quality of life with active treatment of anaemia.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.