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Vol. 149. Issue 11.
Pages 496-503 (December 2017)
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Vol. 149. Issue 11.
Pages 496-503 (December 2017)
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DOI: 10.1016/j.medcle.2017.10.027
Anaemia in the elderly
La anemia del anciano
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Susana Gómez Ramíreza,b, Ángel Francisco Remacha Sevillaa,c, Manuel Muñoz Gómeza,d,
Corresponding author
mmunoz@uma.es

Corresponding author.
a Anemia Working Group España (AWGE), Spain
b Unidad de Gestión Clínica de Medicina Interna, Hospital Clínico Virgen de la Victoria, Málaga, Spain
c Servicio de Hematología, Hospital Sant Pau, Barcelona, Spain
d Medicina Transfusional Perioperatoria, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
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Table 1. Main causes of iron deficiency and maturation factors in the elderly.
Table 2. Characteristics of unexplained anaemia in the elderly.
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Abstract

Anaemia is common in the elderly and is associated with an increased risk of physical, functional, and cognitive impairment, hospitalization and mortality. Although it is unknown whether anaemia is a causal factor or a subrogated marker of worse health status, its correction can improve the patients’ physical and functional capacity. Detection, classification, and treatment of anaemia should be a priority for the health system. The main causes of anaemia in the elderly are nutritional deficiencies and chronic disease, with or without kidney failure, although some cases are of indeterminate origin. Medical history and physical examination help to clarify its aetiology. A diagnostic algorithm based on data from the lab allows anaemia classification with a therapeutic orientation. Supplements of iron and maturation factors, as well as erythropoiesis-stimulating agents, constitute the mainstay of treatment, along with that of the underlying disease, whereas red blood cell transfusion should be reserved for severe cases.

Keywords:
Anaemia
Elderly
Nutritional deficiencies
Erythropoietin
Inflammation
Indeterminate anaemia
Resumen

La anemia es frecuente en los ancianos y se asocia con un mayor riesgo de deterioro físico, funcional y cognitivo, hospitalización y mortalidad. Aunque desconocemos si es un factor causal o un marcador subrogado de un peor estado de salud, su corrección puede mejorar la capacidad física y funcional. Su detección, su clasificación y su tratamiento deberían ser objetivos prioritarios para el sistema de salud. Sus principales causas son las deficiencias nutricionales y las enfermedades crónicas, con y sin insuficiencia renal, aunque algunas son de origen desconocido. La historia clínica y la exploración física ayudan a aclarar su etiología. Un algoritmo diagnóstico basado en los datos del laboratorio permite su clasificación con orientación terapéutica. Los suplementos de hierro y factores madurativos y los agentes estimuladores de la eritropoyesis constituyen la base del tratamiento, junto con el de la enfermedad de base, reservándose la transfusión de hematíes para los casos graves.

Palabras clave:
Anemia
Ancianos
Deficiencias nutricionales
Eritropoyetina
Inflamación
Anemia indeterminada

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