Anemia in the Elderly

Starting from a real-world case vignette illustrating a paradigmatic example of anemia in an elderly patient with multimorbidity, we review the main clinical and pathophysiological aspect of anemia in the elderly, giving some practical insights into how to manage similar cases

Domenico Girelli; Giacomo Marchi; Clara Camaschella

2018

Scholarcy highlights

  • An 81-year-old man, nursing home resident, is known to be affected by multiple comorbidities including: postischemic chronic heart failure with previous myocardial infarction 6 years earlier, reduced ejection fraction at echocardiography, and 1 hospital admission 4 months earlier because of acute heart failure precipitated by a flu-like episode; type 2 diabetes mellitus; stable stage 2 chronic kidney disease with estimated glomerular filtration rate of 60 mL/min; and bilateral coxarthrosis with reduced mobility
  • Regarding the second diagnostic criterion mentioned above, an important lesson has recently come from studies on patients with CHF, in whom a mild anemia is present in up to 50%
  • Even mild anemia in the elderly is independently associated with hard outcomes including quality of life, hospital admissions, and reduced survival
  • Likely more, of AE cases are due to ID, which could be relatively corrected by iron supplementation, using the new i.v. single-dose iron formulations
  • Further research is needed to evaluate the actual benefit of correcting AE in different settings, that is, when inflammation plays a major role, using emerging approaches like antihepcidin agents

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