By
Merritt McKinney, Medical Tribune News Service
Anemia
in elderly patients should not be treated as a normal part of
aging, because it can signal serious underlying disease, a new
study suggests.
People with anemia have low levels of hemoglobin, a substance
in red blood cells that helps to deliver oxygen from the lungs
to the rest of the body.
Anemia
in an elderly patient often does not generate concern among doctors,
since hemoglobin levels tend to decline slightly with age.
But
according to a Dutch report in this week's issue of the Journal
of the American Medical Association, men and women ages 85 and
older who had anemia were about twice as likely to die during
the first five years of a 10-year follow-up period than their
peers who had normal hemoglobin levels. And the more anemic a
person was, the greater his or her risk of death, researchers
reported.
Overall, men with anemia were 2.29 times as likely to die in five
years, while women's risk was multiplied 1.6 times, the study
showed.
When the researchers examined records to verify the cause of death,
they found that anemic men and women were more likely to die from
cancer and infection, both of which may affect hemoglobin levels,
reported a team of researchers led by Dr. Gerbrand J. Izaks of
Leiden University Medical Center.
Symptoms
of anemia vary, but may include fatigue, dizziness, headache and
difficulty breathing during exercise. There are several potential
causes of anemia, including blood loss and iron deficiency.
Because
of the increased death risk, doctors should conduct a thorough
examination of all elderly patients who have low hemoglobin levels,
the researchers concluded.
A expert on blood diseases agreed, calling anemia in the elderly
a ``red flag'' of disease.
Physicians shouldn't discount anemia as a consequence of aging,
commented Dr. Peter D. Emanuel, an associate professor of medicine
at the University of Alabama at Birmingham. They ``should pay
attention to it and look for underlying disease,'' he said.
In
the study, the researchers followed 755 people ages 85 and older.
Blood samples were drawn in 1986, and participants were tracked
until 1996. About 17 percent of the women and 28 percent of the
men had anemia at the beginning of the study period, according
to the report.
At
the end of the study, 86 percent of anemic patients had died,
compared with 65 percent of those with normal hemoglobin levels.
However, anemia was associated with an increased risk of death
only during the first five years of follow-up. During the next
five years, there was not a significant difference in the death
rate among the two groups of people.
Emanuel speculated that people whose anemia resulted from a serious
illness would be more likely to die within five years, which may
explain the increased risk during the first follow-up period.
Five years into the study, when all participants were at least
90 years old, it made sense that the death rates leveled out a
bit, he said.
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