What is anemia?
Anemia is a below-normal level of hemoglobin* or hematocrit*. Hemoglobin is the substance in red blood cells that carries oxygen to all parts of your body. Anemia can be temporary or it can be a long-term disease/illness. People with mild anemia may not have any symptoms or may have only mild symptoms. People with severe anemia can feel tired, get short of breath with activity, and have problems doing the things they usually do.

How common is anemia in older people?
As many as 61% of elderly people have anemia, depending on age, sex, and overall health.¹ The chance of becoming anemic increases after age 65, especially in men.²

What causes anemia in people as they grow older?
There are many causes of anemia. Studies have shown the two major causes of anemia in the elderly are chronic disease and iron deficiency.

• Anemia of chronic disease: Certain chronic diseases can interfere with the production of red blood cells, resulting in chronic anemia. The kidneys produce a hormone called erythropoietin, which stimulates your bone marrow to produce red blood cells. Iron is also needed for red blood cell production.
  
  In anemia of chronic disease a body can not use its stored iron. Erythropoietin is suppressed and the bone marrow does not respond normally. A shortage of iron and erythropoietin can result in a shortage of red blood cells.
• Iron deficiency anemia: can result from chronic, often undetected blood loss. Another cause is from not eating enough iron in your diet, or when your body isn’t absorbing enough iron.

About 20% to 36% of elderly people have idiopathic anemia – meaning no cause for the anemia can be found.

What are the effects of untreated anemia?
Elderly people with anemia are 40% more likely to have problems that keep them from being independent. These problems include poor balance and not being able to walk long distances⁶ and can be prone to falls, have heart trouble, depression, and problems with memory and concentration.^1,7-9

Anemia has been shown to shorten the life expectancy of elderly people.¹⁰ As early as age 65, people with kidney disease, diabetes, and/or heart failure are more likely to die if they have anemia.¹¹ Anemia can also make certain medical conditions worse, so getting treatment is important. This does not guarantee you will live longer if the anemia is corrected, but it shows how important it is to treat your anemia.

How do I know if I am anemic?
Most people do not realize they are anemic until a blood test shows a low hemoglobin or hematocrit. Symptoms and signs usually develop when anemia is moderate to severe, and can include fatigue, weakness, pale skin, chest pain, dizziness, irritability, numbness or coldness in your hands and feet, trouble breathing, a fast heartbeat, and headache. One of the problems in identifying anemia in the elderly is that many of these symptoms are typically associated with getting older. It is important to see your doctor on a regular basis in order to be tested for anemia.

What treatments are available to help me?
Your doctor will provide the treatment that is best for you based on what is causing the anemia. Several medications are approved to help correct anemia. Close communication with your doctor will ensure you will receive the best anemia treatment available.

*Normal Lab Values: Normal hemoglobin > 12 g/dL for women, > 14 g/ dL for men; normal hematocrit >36% for women, >42% for men.

What treatments are available to help me?
Your doctor will provide the treatment that is best for you based on what is causing the anemia. Several medications are approved to help correct anemia, and in certain cases mild anemia due to vitamin deficiencies may be corrected with a change in diet. Folate deficiency in pregnant women can cause serious birth defects, and many processed foods are fortified with folic acid, the manufactured form of naturally occurring folate. Close communication with your doctor will ensure you will receive the best anemia treatment available.

*Normal Lab Values: Normal hemoglobin >= 12 g/dL for women, >= 14 g/ dL for men; normal hematocrit >= 36% for women, >= 42% for men.

References

1. National Anemia Action Council. Anemia: A Hidden Epidemic. Los Angeles, CA: HealthVizion Communications, Inc; 2002.
2. Guralnik JM, et al. Blood. 2004;104(8):2263-2268.
3. Robinson B, et al. J Am Geriatr Soc. 2007;55(10):1566-1570.
4. Artz AS, et al. J Am Geriatr Soc. 2004;52(3):423-427.
5. Joosten E, et al. Gerontology. 1992;38:111-117.
6. Anía B, et al. J Am Geriatr Soc. 1997;45:825-831.
7. Ershler W. J Am Geriatr Soc. 2003;51(suppl):S18-S22.
8. Penninx B, et al. Am J Med. 2003;115:104-110.
9. Herndon J, et al. J Am Geriatr Soc. 1997;45:739-743.
10. Lipschitz D. J Am Geriatr Soc. 2003;51(suppl):S10-S13.
11. Katz I, et al. J Geriatr Psychiatry Neurol. 1993;6:161-169.
12. Izaks G, et al. JAMA. 1999;281:1714-1717.
13. Collins A, et al. Adv Stud Med. 2003;3(3C);S14-S17.

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