Anemia Linked To Decline In Elderly PeopleCause Sometimes Unknown, Experts Say< July 30, 2003 >Anemia doubles the risk that an older person will develop serious physical declines that can erode the ability to live independently, according to a new study reported in the American Journal of Medicine. "This study suggests that even mild anemia is a risk factor linked to reduced ability of older people to function at their fullest potential," said Dr. Jack Guralnik, a co-author of the study and a researcher at the National Institute on Aging (NIA), of the National Institutes of Health (NIH). "Further research will tell us whether the treatment of anemia can prevent the progressive decline in function that eventually results in disability," Dr. Guralnik says. The study reports that even older people with borderline anemia had a higher risk of physical decline. Anemia affects at least 3.4 million US adults. It is the most common blood disorder in the US. It occurs when the body does not produce enough red blood cells or red blood cells are prematurely destroyed. More specifically, it is defined as a low concentration of hemoglobin, the main component of red blood cells that transports oxygen from the lungs to other tissues and then returns carbon dioxide from the body to the lungs. A person who has anemia can feel fatigued, dizzy, apathetic, or irritable. Other common symptoms include muscle weakness, shortness of breath, rapid heart beat, and pale skin. However, the warning signs are often subtle and can be difficult for physicians to detect, experts say. Anemia can be caused by vitamin or mineral deficiencies, particularly of iron, vitamin B12, and folic acid. Underlying diseases including cancer, rheumatoid arthritis, and chronic kidney disease also can trigger anemia. But in up to 25 percent of cases, no cause can be identified. Treatment varies, but dietary changes, nutritional supplements, and medications can help. Elderely Women Affected Most by AnemiaIn the current study, six percent of the participants had anemia and 15 percent had borderline anemia, says Dr. Brenda Penninx, at the Stricht Center for Aging at Wake Forest University School of Medicine, and a co-author of the study. Dr. Penninx says she believes most of the participants were unaware of their anemia. For four years, the researchers followed a group of 1,146 people over age 71. All of the participants lived in Iowa. Nearly 70 percent of the group was female. At the start of the study, and four years later, the participants were asked to perform three routine physical tasks: standing balance, a timed 8-foot walk, and ability to rise from a chair. The researchers also collected blood samples and gathered routine health information, such as smoking status, weight, and blood pressure. At the end of the study, two-thirds of the participants had at least modest declines in physical performance scores, with 346 people (30 percent) having substantial decreases. Overall, those who did not have anemia averaged a 1.4 point decline on the 12-point scale during the study. In contrast, those who had borderline anemia dipped an average of 1.8 points and those with anemia dropped an average of 2.3 points on the 12-point scale. Women with anemia showed the greatest physical decline followed by women who had borderline anemia. Also, men with anemia had significantly greater physical decline than men with normal blood hemoglobin levels. Men with borderline anemia were more likely to show physical decline than those whose hemoglobin levels were slightly higher than the standard. Excluding people who had ailments associated with anemia, such as cancer, kidney disease, and infections, did not change the findings. Anemia Translates to Fatigue and WeaknessDr. Penninx says there are probably several reasons why anemia is linked with physical decline. "Anemia is associated with fatigue, low energy levels, and weakness, which are all conditions that will affect your ability to function," she says. Another reason may be that because of the anemia, the muscles of elderly people may simply not receive enough oxygen to function properly. "I think this study is an interesting first step of research that needs to come," says Dr. Linda Carmosino, at Nassau University Medical Center in East Meadow, N.Y. "The next step would be to see if treating these patients made a difference in their function." Dr. Carmosino says it is also important to realize that anemia is often a sign of underlying disease in the elderly, such as cancer, and that it could be the cancer that is affecting function more than the anemia. Because anemia can be a sign of other medical problems, Dr. Carmosino says it is important to find the cause of the anemia and treat it. If no cause can be found, she says people are sometimes treated with erythropotein, a hormone that stimulates red blood cell production. However, she is uncertain if this type of treatment could reverse the physical declines seen in the study. Dr. Penninx says older people should not assume that fatigue or physical decline is a normal part of aging, and they should talk with their doctor about such symptoms. "Although no study yet shows that treating anemia in older people reduces the incidence of physical decline, our study certainly suggests that this may be the case," Dr. Penninx said. "Anemia deserves clinical attention. That's the take home message." Always consult your physician for more information. Online Resources(Our Organization is not responsible for the content of Internet sites.) Centers for Disease Control and Prevention (CDC) National Heart, Lung, and Blood Institute (NHLBI) National Institute on Aging (NIA) |
For more information on health and wellness, please visit health information modules on this Web site. What Is Anemia?Anemia is a common blood disorder, which is caused when there is a drop in hemoglobin or hematocrit in the blood. Hemoglobin is the part of blood that distributes oxygen from the lungs to tissues in the body. Hematocrit is the measurement of the percentage of red blood cells found in a specific volume of blood. Anemia is often a symptom of a disease rather than a disease itself. Anemia usually develops because of one of these general categories:
What Are the Symptoms of Anemia?Most symptoms of anemia are a result of the decrease of oxygen in the cells or "hypoxia." Because red blood cells, as hemoglobin, carry oxygen, a decreased production or number of these cells result in "hypoxia." Many of the symptoms will not be present with mild anemia, as the body can often compensate for gradual changes in hemoglobin. The following list includes the most common symptoms of anemia. However, each individual may experience symptoms differently. Symptoms may include:
The symptoms of anemia may resemble other blood disorders or medical problems. Because anemia is often a symptom associated with another disease, it is important for your physician to be aware of symptoms you may be experiencing. What Causes Anemia?Generally, anemia may be caused by several problems, including the following:
What Are the Different Types of Anemia?There are several different types of anemia, each with a specific cause and treatment, including the following:
How Is Anemia Diagnosed?Anemia is usually discovered during a medical examination through a routine blood test. In addition to a complete medical history and physical examination, diagnostic procedures for anemia may include additional blood tests and other evaluation procedures. Always consult your physician for more information. |
