Published online by Cambridge University Press: 19 May 2010
GENERAL OVERVIEW OF ANEMIA IN THE ELDERLY
Definition of Anemia
The word anemia is derived from the Greek language and means “bloodlessness” (an = not; haimia = blood). In 1968, the World Health Organization defined anemia as hemoglobin of less than 13 g/dL in males and hemoglobin less than 12 g/dL in females. Those values are widely used for epidemiological studies. These thresholds may not reliably delineate high and low risks of adverse outcomes in elderly patients. In fact, improved overall health measures generally appear to correlate with higher hemoglobin levels, up to the level of approximately 14 g/dL. Increased risk of mortality and functional impairment in women 65 and older was associated with hemoglobin levels of 13.5 g/dL and lower.
Epidemiology of Anemia in Aging Population
The prevalence of anemia in community-dwelling persons increases with age. In persons between 61 and 75 years of age, the prevalence of anemia is between 8% and 15%. Beyond age 75, the prevalence varies from 16% to 26%. In a group of nearly 4,000 adults older than the age of 70 years, anemia was present in 9% of those aged 71–74 years and in 41% of men and 21% of women older than the age of 90. The prevalence of anemia is even higher in residents in long-term care, affecting 31.4%–49% of nursing home residents.
Aging of the Population
Population aging, the process by which older individuals become a proportionally larger share of the total population, was one of the most distinctive demographic events of the twentieth century.