Prevalence and causes of anemia in the elderly.

AbstractThe prevalence and causes of anemia in the elderly were studied in 142 individuals, aged over 60 years, in a small rural community in which a high prevalence of nutritional anemia in pregnancy and childhood was previously shown. The mean Hb level of elderly subjects was slightly but significantly lower than that of the control group of younger individuals. The mild reduction of Hb in the elderly population was paralleled by a slight but significant reduction in serum iron, red cell folates and serum vitamin B12, and by a slight increase in total iron-binding capacity. Therapeutic trial with folic acid failed to improve Hb levels but iron therapy resulted in a significant increase in about one half of the anemic patients. In the rest of the patients, who failed to respond to either folate or iron therapy, anemia was most probably the consequence of underlying chronic disorders. In order to investigate the nature of the diseases associated with anemia, an additional 104 patients aged over 60 years were studied in a general medical ward in Jerusalem. In this group, a primary nutritional anemia could not be implicated in any of the 15 patients with Hb below 11 g/dl, and the most important causes of anemia were chronic renal failure, metastatic carcinoma, gastrointestinal bleeding and infection. These findings indicate that, although diminished serum iron and red cell folate levels may occasionally be found in elderly subjects, nutritional deficiency is seldom responsible for anemia in this age group, and anemia, when present, is usually the manifestation of a chronic underlying disease.