Anemia in Elderly Linked to Declines

Even Mild Anemia Is a Risk Factor for Loss of Physical Function

From the WebMD Archives

July 25, 2003 -- Elderly people with anemia have twice the risk of experiencing physical declines that can end up robbing them of their independence, according to new research supported by the National Institute on Aging.

Wake Forest University researchers report for the first time that anemia is a major risk factor for age-related loss of physical function. Lead researcher Brenda Penninx, PhD, tells WebMD that the findings should help call attention to a condition that is underdiagnosed and undertreated in elderly populations.

"Although we didn't look at treatment in this study, the hope is that by correcting the anemia we can prevent some of the physical declines that we saw," she says. "That could keep older people out of nursing homes and hospitals."

Weakness, Irritability

Roughly 13% of people over the age of 70 are anemic, meaning that their capacity to carry oxygen in the blood is compromised. As a result, people with anemia often feel weak, tired, dizzy, or irritable. If not treated it can force the heart to work harder, leading to more serious consequences.

In elderly people, anemia can often be caused by an underlying disease such as cancer or kidney failure or by treatments for these diseases. Poor nutrition is a less common cause among the elderly, and no cause can be identified in about 30% of cases.

Penninx and colleagues followed a group of 1,146 people over the age of 70 for about four years, during which time they assessed physical abilities such as standing balance, walking, and the ability to rise from a chair. By the end of the study, two-thirds of the participants had experienced some declines and 30% experienced substantial declines.

The researchers also found that elderly people with anemia were associated with a 150% increase in hospitalization risk and a 200% increase in risk of being admitted to a nursing home.

People with borderline anemia were found to be at 1.5 times the risk of those who were not anemic. The findings are published in the August issue of The American Journal of Medicine.

"This study suggests that even mild anemia is a risk factor linked to reduced ability of older people to function at their fullest potential," National Institute of Aging epidemiologist Jack Guralnik, MD, PhD, says in a news release. "Further research will tell us whether the treatment of anemia can prevent the progressive decline in function that eventually results in disability."


Drugs Available to Treat Anemia

American Geriatrics Society spokesman Charles Cefalu, MD, MS, tells WebMD that the diagnosis of anemia among elderly patients has not been a priority in the past because there were no effective treatments for the condition. That changed, however, with the introduction of epoetin alfa, the first drug approved for the treatment of anemia.

The injectable drug is marketed under the brand names Epogen and Procrit. It is approved specifically for anemia related to treatments for kidney failure, HIV, and cancer.

"I think anemia among the elderly will get more attention because of studies like this one and because there is now something that we can do about it," Cefalu says. "We need studies to determine that these emerging treatments are effective for larger populations of anemic patients."

WebMD Health News


SOURCES: American Journal of Medicine, Aug. 1, 2003. Brenda W. Penninx, PhD, associate professor, department of internal medicine and geriatrics, Wake Forest University School of Medicine, Winston-Salem, N.C. Charles A. Cefalu, MD, MS, professor and director for geriatric program development, Louisiana State University, Baton Rouge. Jack Guralnik, MD, PhD, epidemiologist, National Institute on Aging.
© 2003 WebMD, Inc. All rights reserved.


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