Shamaila Burney, Saqib Qayyum Ahmad, Rehan Masroor.
Anaemia in elderly: a benign condition or an early warning? - a hospital based study.
Pak Armed Forces Med J Jan ;66(3):400-6.

Objective: To determine the frequency of etiological subtypes of anaemia in geriatric patients in hospital practice. Study Design: Descriptive study. Place and Duration of Study: Department of Medicine, PAF Hospital Islamabad, from September 2012 to August 2013. Patients and Methods: One hundred elderly patients, aged ≥ 65 years and fulfilling the WHO criteria of anaemia were selected by non probability convenient sampling. Patients were classified according to the severity of anaemia as well as type of anaemia based on morphological findings. Based on clinical evaluation and further laboratory investigations etiological subtypes of anaemia were identified. Results: A cause was determined in 91% patients. Anemia was multifactorial in 19% cases. Iron deficiency anaemia was detected in 42% with 27% subjects having iron deficiency as the sole cause. B12 and folate deficiency was detected in 10% and 7% patients respectively. Anaemia of chronic disease was present in 53% of the patients with renal insufficiency as the most frequent pathology seen in 11% patients. Underlying malignancy was diagnosed in 5% of the total study population. Conclusion: Anaemia in elderly is often multifactorial. A basic workup can reveal the cause of anaemia in most patients. Iron deficiency anaemia is a readily correctible cause of anaemia that frequently results from blood loss in geriatric patients. Occult disease in particular malignancy must be ruled out in all anaemic elderly individuals. Early diagnosis and management of anaemia can have a significant impact on the overall disease outcome in elderly patients and should be part of a comprehensive geriatric assessment.

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