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LETTER TO EDITOR  
Year : 2014  |  Volume : 39  |  Issue : 3  |  Page : 187-188
 

Anemia in elderly: The need to combat the problem


Post Graduate, Department of Community Medicine, Gauhati Medical College, Guwahati, Assam, India

Date of Web Publication19-Jul-2014

Correspondence Address:
Dr Rashmi Agarwalla
Post Graduate, Department of Community Medicine, Gauhati Medical College, Guwahati, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-0218.137163

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How to cite this article:
Agarwalla R. Anemia in elderly: The need to combat the problem. Indian J Community Med 2014;39:187-8

How to cite this URL:
Agarwalla R. Anemia in elderly: The need to combat the problem. Indian J Community Med [serial online] 2014 [cited 2019 Dec 16];39:187-8. Available from: http://www.ijcm.org.in/text.asp?2014/39/3/187/137163


Sir,

The world is going through a demographic transition. The percentage of elderly is increasing at a tremendous rate. The number of elderly globally is projected to grow from an estimated 524 million in 2010 to nearly 1500 million in 2050, with most of the increase in developing countries. [1] According to United Nations Development Programme (UNDP) report 2011, the share of India's elderly is projected to climb from 8% in 2010 to 19% in 2050. The elderly now comprise 8.1% of the total population (census 2011). [2] We are already an aging country as per United Nations definition of Aging Nation. By 2025, it is estimated that the percentage of elderly will cross the percentage of under 5 children. If this particular age group is not given due consideration now, we will be overburdened with another problem along with maternal and child health issues.

While we are still trying to achieve the maternal, newborn and child health indicators as per Millennium Development Goals we are somehow unwilling to look beyond these age groups. An age group which we call our precious resource has definitely been neglected in due course of time.

Although we have many policies made for the elderly like National Policy for Older persons 1999, Maintenance and Welfare of Parents and Senior Citizens Act, 2007, National Programme for Health care of the Elderly, 2010 and National Policy for Senior Citizens, 2011. The question arises how many of them address to the nutritional needs of the elderly and answer the problem of prevalence of anemia in this particular age group.

Although anemia has often been considered a normal consequence of aging, the pathophysiology of such an age-related decline in erythrocyte production is obscure, and efforts to understand anemia in elderly individuals have become a major target of research interest. Recent studies suggest that, although anemia likely arises in part from the cumulative effect of age-related comorbidities and physical decline, there are still age-specific changes in the hematopoietic system that influences red blood cell production. Understanding of these changes could have important diagnostic and therapeutic implications for addressing this common problem. Because the number of elderly individuals is expected to reach unprecedented levels in the 21 st century, anemia represents an emerging global health problem negatively impacting quality of life in a significant proportion of the elderly population and requiring an ever-greater allocation of health care resources. [3]

The prevalence and causes of anemia in community-dwelling older persons in the US were evaluated in the third National Health and Nutrition Examination Survey 1988-1994. In persons 65 years and older, anemia was present in 11.0% of men and 10.2% of women. [4] In large studies of community dwelling older adults from US and Europe, the prevalence rates of anemia ranged from 8% to 25%.Various studies done in India have also shown the prevalence of anemia to be high in elderly. [5],[6]

Even though anemia is fairly prevalent among the elderly, the underlying cause is not so well-defined. Symptoms of fatigue, pale skin, and decreased cognitive ability are easily attributed to getting old. Some physicians feel that mildly lowered hemoglobin level is normal for an older person. This may not always be the cause. With the world's elderly population rising so rapidly, it is evident that the percentage of elderly living with anemia is also expected to increase both in the developed and developing countries. Untreated anemia in elderly can be detrimental, because it is associated with increased mortality, poor health, fatigue, and functional dependence and can lead to cardiovascular and neurological complications. [7] Importantly, studies investigating anemia in older adults and poor outcomes have not been established to design causality. Accordingly, it is unknown whether it is the underlying etiology of the anemia or associated co-morbidities that do so. Nonetheless, it is plausible to suggest that anemia potentially leading to increased cardiac output and/or local tissue hypoxia, could aggravate functional decline in the older adult population. [8] While World Health Organization theme talks about adding life to years in the elderly, preventing, diagnosing, and treating anemia will definitely play a big role in achieving the theme. . There is a definite need to formulate policy and conduct studies in the specific field in order to meet the needs of the elderly. Interventions may play a part in the prevention of degenerative conditions of age, improvement of quality of life, and impact on health care burden and resources.

 
   References Top

1.Global Health and Ageing: National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services, WHO.  Back to cited text no. 1
    
2.Census of India. Registrar General of India office, Government of India, India 2011.  Back to cited text no. 2
    
3.Vanasse GJ, Berliner N. Anemia in elderly patients: An emerging problem for the 21 st century. Hematology Am Soc Hematol Educ Program 2010;2010:271-5.   Back to cited text no. 3
    
4.Woodman R, Ferrucci L, Guralnik J. Anemia in older adults. Curr Opin Hematol 2005;12:123-8.  Back to cited text no. 4
    
5.Purty AJ, Bazroy J, Kar M, Vasudevan K, Veliath A, Panda P-Morbidity pattern among the elderly population in the rural area of Tamil Nadu, India-Turk J Med Sci,2006;-36:45-50.   Back to cited text no. 5
    
6.Sharma MK, Swami HM, Gulati R, Bhatia V, Kumar D. An epidemiological study of correlates of anaemia among elderly aged 65 years and above in UT, Chandigarh. J Indian Acad Geriatr 2006;2:61-5.  Back to cited text no. 6
    
7.Balducci L. Epidemiology of anemia in the elderly: Information on diagnostic evaluation. J Am Geriatr Soc 2003;51(3 Suppl):S2-9.  Back to cited text no. 7
    
8.Price EA, Schrier SL. Anemia in the older adult. Available from: http://www.uptodate.com/contents/anemia-in-the-older-adult. [Last updated 2013 Apr 29].  Back to cited text no. 8
    




 

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