Sunday, December 11, 2005

anemia

anemia
Anemia is a decrease in the blood hemoglobin concentration or erythrocyte mass, which occurs in 5 to 20 percent of the elderly population. It may be caused by inadequate diet, loss of blood, chronic diseases, or industrial poisons. Hemoglobin transports oxygen from the lungs to the tissues of the body and is, along with cardiac  output, a key determinant of how much  oxygen can be transported, delivered, and  consumed. Due to decreased hemoglobin, anemia causes a decrease in oxygen delivery to the body tissues. This causes an increase in cardiac output, which can lead to CONGESTIVE HEART FAILURE, fatigue, and ANGINA.  Symptoms of anemia develop slowly and frequently go unnoticed because they are common to other aging problems.
Symptoms of anemia include fatigue, VERTIGO, congestive heart failure, pedal edema, angina, dyspnea, headaches, confusion, urinary incontinence, increased sensitivity to cold, irritability, pale skin, arrhythmia, spoon-shaped nails, and a red, sore  tongue.
See also ANEMIA, CHRONIC DISEASE; ANEMIA, IRON DEFICIENCY; ANEMIA, MEGALOBLASTIC; FOLIC ACID DEFICIENCY; VITAMIN  B12 DEFICIENCY.
Ham, R. J. Geriatric Medicine Annual-1987.  Oradell, N.J.: Medical Economics Books, 1987.
Reichel, W. Clinical Aspects of Aging. Baltimore:  Williams & Wilkins Co., 1979.


anemia, chronic disease - Chronic disease  anemia refers to anemia that is associated  with chronic inflammatory states such  as RHEUMATOID ARTHRITIS, chronic infections, and malignancies. It is caused by a blockage in the release of iron from the reticuloendothelial cells. It differs from IRON DEFICIENCY ANEMIA in that this anemia is generally mild with a relatively stable course after about one month. Treatment of chronic disease anemia involves establishing the underlying disease and treating that disorder.
Ham, R. J. Geriatric Medicine Annual-1987.  Oradell, N.J.: Medical Economics Books, 1987.
Reichel, W. Clinical Aspects of Aging. Baltimore:  Williams & Wilkins Co., 1979.


anemia, iron deficiency - Iron deficiency  anemia occurs because of improper dietary  intake, poor gastrointestinal absorption, or  blood loss.
The quality and quantity of food a person eats may change as a person ages due to several factors. The expense of a balanced diet with iron-rich foods may become prohibitive for a person who lives on a fixed income. Lack of transportation may limit a person’s purchasing power of fresh foods.  Physical disabilities may impair a person’s willingness or ability to prepare foods properly.  Loss of teeth may result in avoidance of certain foods. Depression may lead to self-neglect and poor nutrition.
Symptoms of iron deficiency anemia include fatigue, VERTIGO, CONGESTIVE HEART FAILURE, pedal edema, angina, dyspnea,  headaches, confusion, urinary incontinence,  increased sensitivity to cold, irritability, pale  skin, arrhythmia, spoon-shaped nails, and  red sore tongue.
Iron supplements are frequently prescribed to replace deficits. Generally, supplements are oral medications, but iron injections  may also be necessary, particularly  when malabsorption, iron intolerance, excessive  iron needs, or noncompliance preclude  the oral treatment. Blood transfusions are rarely necessary and are reserved only for severe cases.
Oral iron therapy can cause gastrointestinal intolerance and severe constipation. This may be particularly bothersome for the elderly  since constipation is frequently a problem  anyway. Laxatives may be necessary while the person is on iron therapy. Since iron supplements are absorbed in the duodenum,  the use of antacids hinders this absorption  and should be avoided.
Nutritional consultation is frequently necessary to educate the patient on the types of foods that should be eaten. These foods include beef, clams, peaches, beans, soybean flour, and liver.
If the anemia is due to blood loss, the patient may be suffering from a gastrointestinal disorder such as a PEPTIC ULCER, DIVERTICULOSIS, HEMORRHOIDS, chronic GASTRITIS, COLON CANCER or HIATAL HERNIA.
Diagnosis of these disorders may require further testing, such as barium studies, stool cultures, or colonoscopies, to determine the  source of bleeding.
Ham, R. J. Geriatric Medicine Annual 1987.  Oradell, N.J.: Medical Economics Books, 1987.
Reichel, W. Clinical Aspects of Aging. Baltimore:  Williams & Wilkins Co., 1979.


anemia, megaloblastic Most megaloblastic  anemias are due to vitamin B12 or  folic acid deficiencies. Symptoms of megaloblastic anemia include neurologic changes,  smooth tongue, confusion, and dizziness.  Treatment for megaloblastic anemia involves properly identifying the deficiency and replacing it. Replacement can be accomplished by a proper diet and supplemental oral folic acid or vitamin B12.
See also FOLIC ACID DEFICIENCY; VITAMIN B12 DEFICIENCY.
Ham, R. J. Geriatric Medicine Annual 1987.
Oradell, N.J.: Medical Economics Books, 1987.  Phipps, W. J., et al. Medical Surgical Nursing.  St. Louis: C. V. Mosby Co., 1983.
Reichel, W. Clinical Aspects of Aging. Baltimore:  Williams & Wilkins Co., 1979.


anemia, pernicious See VITAMIN B12 DEFICIENCY.

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