Evaluation and management of anemia in older individuals

Anemia is a very common and sometimes unrecognized clinical diagnosis in the elderly. In addition to the symptoms attributable to anemia itself, anemia may point towards the existence of underlying nutritional deficiencies, inflammatory conditions or chronic diseases. In particular, chronic kidney disease and its associated anemia remain underdiagnosed in older individuals. A calculated creatinine clearance should be carried out to identify individuals with chronic kidney disease. The consequences of anemia in the elderly include physical deconditioning, disability and increased mortality. The importance of an accurate diagnosis and classification of anemia is critical, as therapeutic interventions can improve levels of hemoglobin and thus quality of life in elderly patients. These positive outcomes for treating anemia, such as improved quality of life, decreased hospitalization and decreased mortality, demand that a hemoglobin concentration of less than 12 g/dl should be investigated and treated whenever possible. The availability of recombinant erythropoietin has advanced the ability to correct anemia and improve patient outcome.