Treatment of anemia in the aged: a common problem and challenge

The occurrence of anemia in a group of aged persons residing in a home for the aged and in a chronic disease hospital was reviewed with regard to etiology, choice of treatment, and therapeutic response. Of the 484 patients, 151 (31 per cent) had anemia or were receiving antianemia therapy. Iron-deficiency anemia was the most common type, and iron was the most common form of treatment. Seventy-eight patients were given antianemia therapy in 97 courses, and a good therapeutic result was achieved in about one-fourth of the courses. The most frequent error in iron therapy was its use in the anemia associated with chronic disorders. Often there was a combination deficiency of iron, vitamin B12 and folic acid. The response to iron in the elderly can be very slow, so therapy should not be discontinued too soon. Anemia may directly contribute to other serious pathologic conditions, especially in aged persons with impaired circulation. In some cases the physiologic concentration of hemoglobin may be higher than the accepted "normal" value. The course of the anemia in relation to the general state of the patient is more significant than any laboratory data in choosing antianemia therapy. Practical laboratory screening procedures for elderly anemic patients are discussed.