Clinical Hematological Evaluation of Geriatric Anemia in Elderly

INTRODUCTION: Anemia in the elderly is most common problem that is associated with high morbidity and poor health related quality of life, regardless of the underlying cause of the low haemoglobin. In various studies the prevalence is reported as 10 to 45% of elderly population. Among those older than 60 years, anemia has been associated with increased frailty, poor exercise performance, diminished cognitive function, risk of developing dementia, decreased mobility, increased risk of recurrent falls, low bone density, low skeletal muscle density and an increased rate of major depression. Anemia can be a marker for more severe disease or an indicator of lower likelihood to respond to current therapies. AIM OF THE STUDY: To Evaluate Clinical, Hematological patterns of Anemia in elderly. OBJECTIVES: PRIMARY OBJECTIVE: To Study the clinico hematological patterns of anemia in elderly aged 60 years and above . SECONDARY OBJECTIVE To detect the morphological types of anemia prevalent among the elders in the age group of 60 years and above. MATERIALS AND METHODOLOGY: STUDY DESIGN: Cross-sectional study. STUDY POPULATION: Older patients > than 60yrs, diagnosed as anemia. STUDY LOCALITY: In PSG Hospitals Male & Female medical wards (inpatients). INCLUSION CRITERIA: Male patients aged 60 years and above with Hb%< 12 gm/dl. EXCLUSION CRITERIA: Patients below 60 years of age. METHODOLOGY: METHODS OF COLLECTION OF DATA- A detailed clinical history shall be recorded and a thorough physical examination shall be done. Complete blood picture including haemoglobin estimation, hematocrit, red blood cell count, white blood cell count, differential count, platelet count, red blood cell indices. (MCV, MCH, MCHC) And red cell distribution width, anemia profile, fasting B12, serum folatelevel, peripheral smear examination and reticulocyte count shall be done. Special investigations including bone marrow examination, iron studies,hemoglobin electrophoresis, radiological studies, stool, urine examination, liver function tests and renal function tests shall be done whenever necessary. RESULTS: We have done this study in 100 patients of elderly, more than 60years old. Our study showed various types of Anaemia in various percentages. It follows. IDA- 35%, AOCD-40%, megaloblastic-10%, dimorphic-7%, others includes haematological malignancies (8%). Our study reports compared with various study reports. In our study, we collected 100 elderly patients (>60years) diagnosed with Anemia. The inclusion & Exclusion criteria of the study protocol were fulfilled. Distribution of study participants according to age: (N=100) in our study, 60-70 years age group patients are high & >90yrs are low. Mean age of the study population is 71.4years. Distribution of study participants according to gender: (N=100) in our study 55% of male & 45% of female patients were taken. In this study 8% of patients had mild anaemia, 50% of patients had moderate anaemia. 27% of patients had severe anaemia. Comparing our study with NHANES-III study, shows 11% in men, 10.2% in women. AOCD of NHANES-III was 19.7%, in our study it was 40%. IDA of NHANES-III was 16.6% & our study shows 35%. CONCLUSION: Most frequent etiologies in our Indian standards in Anemia of Elderly are AOCD, IDA, B12 & folate deficiency, hematologic malignancies (includes MDS). Multiple concomitant etiologies will be present. Our diagnostic workup should be straightforward, not very invasive. Nutrient deficiency corrected by supplementing it. AOCD/inflammation is treated by finding & curing the underlying cause. If GFR is decreased treat with Erythropoietin. For hematologic malignancies benefit from supportive care or oral Thalidomides. Blood transfusion if necessary to be done