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Hematology 2005
© 2005 The American Society of Hematology

Anemia in the Elderly: A Public Health Crisis in Hematology

Jack M. Guralnik, William B. Ershler, Stanley L. Schrier and Vincent J. Picozzi

Correspondence: Vincent Picozzi, MD, Virginia Mason Clinic, 1100 Ninth Avenue, Seattle WA 98101-2799; Phone (206) 223-6193, Fax (206) 223-6914, hemvjp{at}vmmc.org

Abstract

Over 3 million people in the United Staes aged 65 years and older are anemic. This condition is associated with significant functional impairment and, perhaps, increased mortality. In March 2004, the American Society of Hematology (in conjunction with the National Institute of Aging) convened a "blue ribbon" panel of twenty physicians who are experts on various aspects of this topic. This paper highlights important consensus concepts resulting from that meeting. In particular, four areas of thought are shared. First, the epidemiology of anemia in the elderly is reviewed, including its definition, its expression in different racial groups, and its wide-ranging manifestations. Second, the pathophysiology of anemia in the elderly is reviewed as pertains to three general etiological categories (nutritional, chronic diseases, and so-called "unexplained" anemias). Particular emphasis is given to pathophysiologic mechanisms of anemia that are potentially unique to this age group. Third, a practical approach to the diagnosis and management of anemia for this patient population for the practicing hematologist is provided. Finally, the public health implications of anemia in the elderly for key stakeholder constituencies will be discussed in the oral presentation.


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Copyright © 2005 by the American Society of Hematology.