Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 562
Conclusion
ОглавлениеIn conclusion, anaemia, which is defined as a haemoglobin level less than 13 g/dL in men and less than 12 g/dL in women, frequently presents as a diagnostic challenge in older adults. While common with the ageing process, anaemia is not considered normal, and a workup should be pursued in most cases because of the association between anaemia and quality of life, morbidity, functional status, frailty, cognitive decline, depression, and fractures. Despite these positive associations, anaemia is frequently underdiagnosed and undertreated in older adults. It is typically classified by aetiology, including impaired production of RBCs (nutritional deficiencies, chronic inflammation, and clonal disorders), acute or chronic loss of RBCs (bleeding), and accelerated RBC destruction (haemolytic and sickle cell anaemia). The most common form of anaemia in older adults is anaemia of chronic disease, while the most common type of anaemia at the population level across age groups is iron deficiency anaemia. The nutritional deficiency anaemias (iron, folate, and vitamin B12 deficiency anaemia) tend to be the easiest to correct, while those due to inflammation (anaemia of chronic disease and anaemia of chronic kidney disease) are more difficult to correct because the underlying inflammation is not typically treatable. Anaemias from clonal disorders require urgent haematological specialist referral and in‐depth cytogenetic and molecular bone marrow analyses.