Anemia in institutionalized elderly patients

In a one-year period (1976--1977), 161 residents of a long-term facility were evaluated. There were 44 men and 117 women. According to criteria established by the World Health Organization, 64 residents (40 percent) were anemic. The incidence was greater for women than for men. The peak incidence occurred in the 71--80 age group for women, and in the 90+ age group for men. Iron deficiency secondary to surgical procedures, gastrointestinal bleeding or anticoagulant therapy was the most common cause of correctable anemia. Of the 64 anemic patients, 42 percent responded to therapy. Anemia among the elderly in institutions is often reversible, unlike the anemia of chronic disease. Evaluation should include a careful history and physical examination plus readily available laboratory findings. Invasive procedures are rarely indicated.