By Lodovico Balducci, William B. Ershler, John M. Bennett
Anemia within the aged has been competently outlined because the silent epidemic, representing three million humans within the usa elderly sixty five years and older. occurrence and incidence of this situation bring up with age. It differs in its etiology, pathogenesis and remedy from anemia in young ones and more youthful adults. Anemia is linked to decreased survival, elevated danger of practical dependence and hospitalization, elevated hazard of congestive middle failure and degree renal affliction and cognitive problems. nearly 70% of anemia in older participants is reversible.
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Additional resources for Anemia in the Elderly
First, iron-deficient erythropoiesis occurs when the percent transferrin saturation falls into the range of 15–20%. However, it is important to realize that no transferrin saturation, by itself, is absolutely diagnostic of IDA. As discussed in the chapter on the anemia of chronic inflammation (ACI), there can be very rapid changes in the serum iron as a result of the effect of hepcidin to reduce iron absorption and, particularly, hepcidin’s effect on blocking the release of iron from reticuloendothelial cells.
4). Evidence of iron-deficient erythropoiesis with a serum ferritin >200 ng/mL suggests ACI, while a serum ferritin <12–15 ng/mL is diagnostic of (at least) depleted iron stores. However, if there is doubt, one can obtain a bone marrow specimen and stain the specimen for iron. An underutilized approach to distinguish IDA from ACI combines the serum ferritin level with the sTfR protein level. As reported by Punnonen et al. 4. The anemia of chronic disease and iron deficiency: similarities and differences Iron deficiency anemia Low serum iron ACD Low serum iron High TIBC Normal to low TIBC Low % Tf saturation Low % Tf saturation Elevated red cell protoporphyin Elevated red cell protoporphyrin Red cell microcytosis Normocytic to microcytic red cells Low serum ferritin Normal to elevated ferritin Absent marrow iron stores; no sideroblasts Marrow iron stores normal to increased; reduced sideroblasts sTrR/log ferritin < 1 sTrR/log ferritin < 2 3.
Currently there is no proof that management of anemia of aging with erythopoietic growth factors is beneficial. This issue should be tested in randomized controlled trials. References 1. US life tables 2. Pitsenberger DH: Juggling work and elder caregiving: work-life balance for aging American workers. AAOHN J. 2006 Apr;54(4):181–5 3. Chapman DP, Williams SN, Strine TW et al: Dementia and its implications for public health. Prev Chronic Dis. 2006 Apr;3(2):A34. Epub 2006 4. Liao I, McGee DL, Cao G et al: Quality of the last year of life of older adults: 1986 vs 1993.