Feature Articles

Anemia is Not a Normal Consequence of Aging

July 16, 2008

older couple bikingAnemia is a common condition in people over age 65, affecting more than 3 million people in the United States.1 Anemia is considered by many to be a relatively harmless and a normal part of the aging process. In fact, anemia is neither normal nor harmless and if left untreated can have far reaching effects on your health, welfare and independence.

For many, anemia may simply be a result of a poor diet, but it can also be caused by an underlying disease. As early as age 65, people with kidney disease, diabetes, and/or heart failure are more likely to die if they have anemia.2 Failure to recognize and treat anemia in the elderly could lead to decreased physical performance, strength and balance – all of which increase the risk of death. Elderly people who are anemic have up to three times higher risk for injuries due to falls (such as hip fractures or head injuries) than non-anemic people of the same age.3 The risk of falls and the consequences of falling have come to be recognized as a factor in determining an aging person’s ability to live independently.

Dementia is another symptom thought to be associated simply with aging. Senior citizens finding it difficult to think clearly may be suffering from anemia rather than experiencing the early signs of dementia. This relationship between anemia and impaired thinking was seen in a recent study conducted by Johns Hopkins.4

More Anemia & Aging Information

See the information handouts to patients, including one describing Anemia & Aging.

Anemia Can be Treated

The good news is that anemia can be treated, and benefits such as increased energy, activity level and improved quality of life can be achieved. Additionally, you’ll have a better chance of responding positively to the treatments for some of the underlying chronic diseases of which anemia is a symptom.

Symptoms of Anemia

Symptoms can include headache, fatigue, weakness, pale skin, dizziness, irritability, numbness or coldness in the hands and feet, trouble breathing, chest pain or a fast heartbeat. If you’ve been feeling some of these symptoms and think you may have anemia, we recommend you see your doctor. To help you, see the anemia Symptoms Quiz for you to fill out and take with you to discuss with your doctor. If you are diagnosed with anemia, there are treatments available.

Causes of Anemia

There are three general causes for anemia in the elderly. See the Information Handouts which explain in-depth some of the specific causes listed below.

  • Nutritional deficiencies and blood loss account for about one-third of anemia cases in the elderly. These include deficiencies of iron or less frequently, of vitamin B12 and folic acids. They can often be corrected by dietary changes or iron and vitamin supplementation. Blood loss as a causal factor (from surgery, injuries, and gastrointestinal and genitourinary bleeding) is more common in hospitalized patients.
  • Chronic illness is the cause for another one-third of geriatric anemia cases. Certain chronic diseases, such as diabetes, chronic kidney disease and cancer can interfere with the production of red blood cells and the utilization of iron, resulting in anemia.
  • A cause cannot be determined in about one-third of anemia cases in the elderly. There may be many reasons why a cause is not found, but some doctors believe it is due to mild or unrecognized chronic conditions.

What can you do to prevent anemia?

Necessary Nutrients

Important nutrients for making healthy red blood cells and preventing anemia include:

  • Iron
  • Folic Acid
  • Vitamin B12
Read the article Anemia and Nutrition for more information on eating healthy to prevent anemia.

Many kinds of anemia, especially those caused by deficiencies of iron or vitamins, may be avoided by eating a diet rich in iron, folic acid and vitamin B12, or by taking the appropriate supplements. The best sources of iron are beef and other meats. Other iron-rich foods include beans, lentils, iron-fortified cereals, dark green leafy vegetables, dried fruit, nuts and seeds. Folic acid can be found in citrus juices and fruits, dark green leafy vegetables, legumes and fortified breakfast cereals. Vitamin B12 is plentiful in meat and dairy products. Vitamin C also helps your body absorb iron and can be found in citrus fruits. For more about eating healthy to prevent anemia, read the article, “Anemia and Nutrition”.

Other kinds of anemia can be prevented by treating the underlying cause. Most kinds of anemia can be prevented from becoming serious by reporting the signs and symptoms to your doctor. It is also important for your doctor to perform the correct tests to diagnose anemia and to follow specific directions for treatment. Several medications are approved to help correct anemia and we encourage close communication with your doctor.


  1. Guralnik JM, Ershler WB, Schrier SL, Picozzi VJ. Anemia in the elderly: a public health crisis in hematology. Hematology Am Soc Hematol Educ Program. 2005:528-32.
  2. Katz IR, Beaston-Wimmer P, Parmelee P, Friedman E, Lawton MP. Failure to thrive in the elderly: exploration of the concept and delineation of psychiatric components. J Geriatr Psychiatry Neurol. 1993 Jul-Sep;6(3):161-9.
  3. Duh MS, Mody SH, Lefebvre P, Woodman RC, Buteau S, Piech CT. Anaemia and the risk of injurious falls in a community-dwelling elderly population. Drugs Aging. 2008;25(4):325-34.
  4. Chaves PH, Carlson MC, Ferrucci L, Guralnik JM, Semba R, Fried LP. Association between mild anemia and executive function impairment in community-dwelling older women: The Women's Health and Aging Study II. J Am Geriatr Soc. 2006 Sep;54(9):1429-35.