Investigating Iron Deficiency Anaemia in the Elderly.

Area of Science:

• Gastroenterology
• Geriatrics
• Internal Medicine

Background:

• Iron deficiency anaemia (IDA) in the elderly is often linked to gastrointestinal (GI) blood loss, necessitating investigation.
• Endoscopic procedures in elderly patients carry increased risks due to comorbidities and frailty.

Purpose of the Study:

• To evaluate outcomes of elderly patients with IDA.
• To identify underlying causes of IDA in this population.
• To assess one-year mortality rates in elderly patients with IDA.

Main Methods:

• Recruited patients aged 75 years and older referred for IDA investigation.
• Collected data on demographics, comorbidities (Charlson Comorbidity Index - CCI), and investigations performed.
• Recorded one-year mortality rates.

Main Results:

• 92 elderly patients (mean age 81.2 years) were included; 70.7% were female with a mean CCI of 5.96.
• Frailty prevented investigation in 13%. Malignancy was diagnosed in 6.5% of patients.
• One-year mortality was 28%, significantly higher in care home residents (p=0.03). Each CCI point increased mortality odds by 40% (OR=1.40).

Conclusions:

• Elderly patients with IDA often present with high CCI scores, making standard endoscopy high-risk.
• High CCI and residing in a care home are independent risk factors for one-year mortality.
• Alternative diagnostic strategies like trans-nasal endoscopy and CT colonography should be considered first-line.