title: Anemia in the elderly: usefulness of an easy and comprehensive laboratory screen.
abstract: Anemia, the most common hematological disorder in the elderly, increases the risk of mortality and morbidity and adversely affects quality of life. However, few studies focused specifically on anemia in the elderly, especially regarding the underlying causes. The main objective of this prospective study was to evaluate the causes of anemia in non-institutionalized elderly patients. We included 190 consecutive patients ≥70 years, admitted to a geriatric short-stay unit over a 1-year period. When the hemoglobin level was <120 g/L, the following serum assays were performed routinely: iron, ferritin, transferrin saturation, folate, vitamin B12, C-reactive protein, TSH, albumin, and haptoglobin. When these tests were normal, bone marrow aspiration was performed to look for myelodysplastic syndrome. Hemoglobin was <120 g/L in 83 (43.7%) of 190 included patients. Patients with anemia had a mean hemoglobin level of 105 ± 11 g/L. The most common potential causes of anemia were inflammation, severe renal impairment, severe malnutrition, and iron deficiency; each of these causes was found in at least one-third of patients with anemia. Myelodysplastic syndrome was found in all anemic patients with a normal serum screen (12/83, 14.5%). Anemia was multifactorial in most patients: the mean number of potential causes per patient was 1.85 ± 1, and 65.4% of the patients had two to four concomitant causes. The serum screen used in our study is easy to perform in ambulatory patients and identifies potential causes of anemia for which safe and effective treatments are available. Second-line bone marrow aspiration adds to the diagnostic yield.
authors.affiliation: Unité gériatrique aiguë, Paris, France. eric.pautas@cfx.aphp.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Pautas
authors.forename: Virginie
authors.initials: V
authors.lastname: Siguret
authors.forename: Thi Mai Anh
authors.initials: TM
authors.lastname: Kim
authors.forename: Pascal
authors.initials: P
authors.lastname: Chaïbi
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Golmard
authors.forename: Adeline
authors.initials: A
authors.lastname: Gouronnec
authors.forename: Valérie
authors.initials: V
authors.lastname: Nivet-Antoine
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gouin-Thibault
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000418:Albumins / Q000378:metabolism; D000704:Analysis of Variance; D000740:Anemia / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood*; D001856:Bone Marrow Examination; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000097:blood; D005492:Folic Acid / Q000097:blood; D005853:Geriatrics; D006242:Haptoglobins / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014168:Transferrin / Q000378:metabolism; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D000418:Albumins; D015415:Biomarkers; D006242:Haptoglobins; D006454:Hemoglobins; D014168:Transferrin; D002097:C-Reactive Protein; D005293:Ferritins; D005492:Folic Acid; D007501:Iron; D014805:Vitamin B 12