L. Suja, Cherian Thampy, P. V. Bhaskar Reddy, Krishnamoorthy S
BACKGROUND The prevalence of anaemia in elderly population is of great significance as it is a manifestation of the underlying disease and produces severe complications in the elderly. The etiopathogenesis of anaemia in this population is multifactorial and its evaluation helps us to rectify and contribute to the overall better outcome in terms of quality of life. Hence our study was focussed on finding the incidence of moderate to severe anaemia in elderly hospitalised patients, and also to identify the aetiology. METHODS This observational study was done in a tertiary care centre on a cohort of 100 patients by screening all patients aged 60 years and above, with haemoglobin of 8 gm/dl and below, admitted in medical ward, for a period of one year. The participants were evaluated with detailed history, clinical examination, complete hemogram and peripheral smear, and routine lab parameters. Special tests like ferritin, TIBC, stool examination, imaging, UGI scopy and colonoscopy, bone marrow studies, and serum electrophoresis, were done on case to case basis. Statistical analysis was done by SPSS method. RESULTS Out of the 100 study subjects, 54% were males, and 46% were females. The maximum number of patients were in the age group 60-69 years. The mean age was 71.3 years. Fatigue was the predominant complaint (41%). The subjects were divided into microcytic anaemia (53%), normochromic anaemia (31%) and macrocytic anaemia (16%). Further evaluation was done to identify the aetiology of anaemia, majority (47%) of the patients had anaemia of chronic disease (ACD) followed by iron deficiency anaemia (37%) and megaloblastic anaemia (16%). In our study, we identified the most common cause of moderate to severe anaemia in elderly hospitalised population as anaemia of chronic disease in which anaemia of CKD is the predominant cause followed by gastrointestinal malignancies. Iron deficiency and vitamin B12 deficiency were the next common cause of moderate to severe anaemia in the elderly in which nutritional deficiency was common. CONCLUSIONS Anaemia is an important cause of mortality and morbidity in the elderly. Characteristics of anaemia in elderly by systematic algorithm will help to identify and formulate the appropriate management which would definitely improve the quality of life.
