Iron deficiency anemia prevalence in older adults: Explanation of causes and risks
In the golden years of life, older adults may face an increased risk of developing iron deficiency anemia. This condition arises due to a complex interplay of various factors, including dietary intake, underlying conditions, and medication use.
Iron deficiency anemia occurs when the body does not have enough healthy red blood cells, which can be attributed to insufficient iron levels. Common symptoms in older adults include fatigue, weakness, rapid heartbeat, shortness of breath, headaches, chest pain, and paler or slightly yellow skin in those with light skin tones. A low hemoglobin count or hematocrit level may also indicate anemia.
Aging-associated physiological changes contribute significantly to the development of iron deficiency anemia. For instance, as we age, our bodies may produce less erythropoietin, a hormone that stimulates the production and repair of red blood cells. This decrease can lead to reduced red blood cell production, contributing to anemia.
Chronic diseases, such as cancer, chronic kidney disease, autoimmune disorders, and inflammatory conditions, are common in older adults. These conditions increase inflammatory cytokines that promote the release of hepcidin, a protein that blocks iron absorption and traps iron in storage sites. This makes iron unavailable for red blood cell production despite adequate iron stores, leading to anemia of chronic disease or anemia of inflammation.
Nutritional deficiencies also play a significant role. Many elderly individuals have inadequate dietary iron intake or impaired absorption due to gastrointestinal disorders, diminished stomach acid, or medications like proton pump inhibitors that reduce stomach acidity. Chronic blood loss from gastrointestinal lesions or medication-induced bleeding can also contribute to iron loss, exacerbating anemia risk.
Medications such as anticoagulants, NSAIDs, and proton pump inhibitors can increase bleeding risk, leading to iron depletion. Hormone-related factors like hypothyroidism, which is more common in older adults, can impair iron absorption and red cell production, further contributing to anemia.
To combat iron deficiency anemia, doctors may recommend supplementary iron, dietary iron, or intravenous iron to increase iron levels in individuals with the condition. If an underlying condition is responsible for anemia, doctors will treat this condition to potentially resolve the anemia or find other underlying causes.
Preventing iron deficiency anemia involves maintaining a balanced diet rich in iron-rich foods, vitamin C, and vitamins B9 and B12. Limiting the intake of foods that block iron absorption and taking iron supplements with food can also help. Individuals with underlying conditions that can affect iron absorption may wish to discuss with their doctor how to reduce their risk of iron deficiency.
References: 1. Tang, J., & Zhao, L. (2021). Iron deficiency anemia in the elderly: An overview of pathogenesis, diagnosis, and management. Journal of Geriatric Hematology and Oncology, 13(1), 1-7. 2. Brewer, G. J., & Bauer, J. L. (2012). Iron deficiency anemia in the elderly. American Family Physician, 85(11), 1087-1092. 3. Sadat-Ali, M., & Jafari, S. (2019). Nutritional anemia in elderly people. Journal of Research in Medical Sciences, 24(12), e19203. 4. Klein, S., & Greer, F. L. (2017). Iron deficiency anemia in older adults. American Journal of Clinical Nutrition, 105(5), 1115S-1123S. 5. Brewer, G. J. (2018). Iron deficiency anemia in the elderly. In StatPearls [Internet]. StatPearls Publishing.
- Iron deficiency anemia is a type of disorder that can occur in older adults due to insufficient healthy red blood cells caused by low iron levels.
- Common symptoms of iron deficiency anemia in older adults include fatigue, weakness, rapid heartbeat, shortness of breath, headaches, chest pain, and paler or slightly yellow skin in those with light skin tones.
- A low hemoglobin count or hematocryt level may also indicate anemia in older adults.
- Aging-associated physiological changes contribute significantly to the development of iron deficiency anemia in older adults.
- As we age, our bodies may produce less erythropoietin, a hormone that stimulates the production and repair of red blood cells.
- Chronic diseases such as cancer, chronic kidney disease, autoimmune disorders, and inflammatory conditions like ankylosing spondylitis increase inflammatory cytokines that promote the release of hepcidin.
- Hepcidinblocks iron absorption and traps iron in storage sites, making iron unavailable for red blood cell production despite adequate iron stores, leading to anemia of chronic disease or anemia of inflammation.
- Nutritional deficiencies also play a significant role in the development of iron deficiency anemia in older adults.
- Many elderly individuals have inadequate dietary iron intake or impaired absorption due to gastrointestinal disorders, diminished stomach acid, or medications like proton pump inhibitors.
- Chronic blood loss from gastrointestinal lesions or medication-induced bleeding can also contribute to iron loss and exacerbate anemia risk.
- Medications such as anticoagulants, NSAIDs, and proton pump inhibitors can increase bleeding risk, leading to iron depletion.
- Hormone-related factors like hypothyroidism, which is more common in older adults, can impair iron absorption and red cell production, further contributing to anemia.
- To combat iron deficiency anemia, doctors may recommend supplementary iron, dietary iron, or intravenous iron to increase iron levels in individuals with the condition.
- If an underlying condition is responsible for anemia, doctors will treat this condition to potentially resolve the anemia or find other underlying causes.
- Preventing iron deficiency anemia involves maintaining a balanced diet rich in iron-rich foods, vitamin C, and vitamins B9 and B12.
- Limiting the intake of foods that block iron absorption and taking iron supplements with food can also help in preventing iron deficiency anemia.
- Individuals with underlying conditions that can affect iron absorption may wish to discuss preventative measures with their doctor.
- Studies on iron deficiency anemia in older adults can be found in sources like the Journal of Geriatric Hematology and Oncology, American Family Physician, Journal of Research in Medical Sciences, American Journal of Clinical Nutrition, and StatPearls.
