-

Abstract

Anemia is an important health problem in all age groups as well as in the elderly. Of the Turkish population, people over 65 years and over account for 7.2%. It is predicted that by 2025 one out of every ten people will be “aged” with the improvement of life standards and health care services. Studies carried out on the elderly population have shown anemia cases ranging between 3-61%. The symptoms of anemia are not different in the elderly from any other age groups but while the young and children can tolerate much better, tolerability is decreased in the elderly because of poor compensation. Being the symptom of many diseases, anemia also brings about some undesirable consequences. There are also studies demonstrating the connection between the existence of anemia in the elderly and increased rate of mortality, deteriorated cardiovascular disease progression, declined cognitive and physical functions, and increased risk of falling down and fractures

Keywords

• -

Yaşlılarda Anemi ve Klinik Etkileri

Abstract

Anemi tüm yaş gruplarında olduğu gibi yaşlılarda da önemli bir sağlık sorunudur. Ülkemiz nüfusunun %7.2 si 65 yaş ve üzerindedir. Yaşam standartları ve sağlık hizmetlerinin gelişmesi ile birlikte yaşlı nüfus artmaktadır ve 2025 yılında her 10 kişiden birinin „yaşlı‟ olacağı öngörülmektedir. Yaşlı nüfus üzerinde yapılan çalışmalarda %3-61 arasında değişen oranlarda anemi bildirilmiştir.Yaşlılarda anemi semptomları diğer yaş gruplarından farklı değildir ancak gençler ve çocuklar semptomları daha iyi tolere ederken yaşlılarda yetersiz kompansasyon nedeni ile tolerans azalmıştır. Anemi pek çok hastalık durumunun belirtisi olmanın yanında bazı istenmeyen sonuçları da beraberinde getirir. Yaşlılarda anemi varlığının artmış mortalite, kardiyovasküler hastalıkların seyrinde kötüleşme, kognitif ve fiziksel fonksiyonlarda bozulma, artmış düşme ve kırık riski ile de ilişkili olduğuna dair çalışmalar vardır

Keywords

• Anemi, Yaşlılık, Aneminin Etkileri

References

1. de Benoist B, Erin McLean, Egli I, Cogswell M (Eds). Worldwide prevalence of anaemia 1993 2005 WHO Global http://www.who.int/vmnis/publications/anaemia_prevalence/en/index.html erişim tarihi 28.03.2012. on Anaemia. Geneva: WHO, 2008. Erişim adresi:
2. Lichtman MA, Williams JW. Hematology in the aged. in: Beutler E. Lichtman MA, Coller BS, Kipps TJ, Seligsohn U. Williams Hematology 8th ed. New York: McGraw-Hill Companies, 2001;8: 93-102.
3. Balducci L. Epidemiology of anemia in the elderly: information on diagnostic evaluation. J Am Geriatr Soc 2003;51(3):2-9 (Review).
4. Den Elzen WP, Gussekloo J. Anaemia in older persons. Neth J Med. 2011;69(6):260-7. Review.
5. Gaskell H, Derry S, Andrew MR, McQuay HJ. Prevalence of anaemia in older persons: systematic review. BMC Geriatr 2008;8:1.
6. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 104(8):2263-8.
7. Fleming DJ, Jacques PF, Tucker KL, et al. Iron status of the free-living elderly Framingham Heart Study cohort: an iron-replete population with a high prevalence of elevated iron stores. Am J Clin Nutr 2001; 73(3):638-46.
8. Artz AS, Fergusson D, Drinka PJ, Gerald M, Bidenbender R, Lechich A, et al. Mechanisms of unexplained anemia in the nursing home. J Am Geriatr Soc 2004; 52(3):423-7.

9. Çoban E, Akın M, Aykut A, Timurağaoğlu A. Yaşlı hastalarda anemi sıklığı ve morfolojik olarak dağılımı. Türk Geriatri Dergisi 2004;7(3):131-2.
10. Erkan E, Muslu M, Sandıkçı S. Yaşlı Hastalarda Anemi Prevalansı ve Klinik Özellikleri. Akad Geriatri 2011;3:29-34.
11. Harman D. Aging: overview. Ann N Y Acad Sci 2001;928:1-21.
12. WHO Expert Commitee. Health of elderly. Geneva. World Health Organization; 1989. Technical Report Series 779. Erişim adresi: http://whqlibdoc.who.int/trs/WHO_TRS_779.pdf erişim tarihi : 03.04.2012.
13. World Health Organization Global Health Observatory (GHO) Life expectancy at birth, erişim adresi: http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends/en/index.html erişim tarihi: 27.03.2012.
14. World POPClock Projection erişim adresi: http://www.census.gov/population/popclockworld.html erişim tarihi: 13.03.2012.
15. TÜİK nüfus istatistikleri ve projeksiyonları TÜİK haber bülteni sayı 19. 28 0cak 2011. erişim adresi: tuik.gov.tr/preHaberBultenleri. Erişim tarihi: 13.03.2012.
16. Sayınalp N. Anemilere genel yaklaşım içinde: İliçin G, Biberoğlu K, Süleymanlar G, Ünal S. Temel iç hastalıkları, 3. Baskı. Ankara: Güneş Tıp Kitabevi, 2012:1592-3.
17. Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med 2006;119(4):327-34.
18. Eisenstaedt R, Penninx BW, Woodman RC. Anemia in the elderly: Current understanding and emerging concepts Blood Reviews 2006; 20(4):213-26.
19. Chaves PH, Xue QL, Guralnik JM, Ferrucci L, Volpato S, Fried LP. What constitutes normal hemoglobin concentration in community-dwelling disabled older women? J Am Geriatr Soc 2004; 52(11):1811-6.
20. Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc 2004;52(5):719-24.
21. Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR. Impact of anemia on hospitalization and mortality in older adults. Blood 2006;15;107(10):3841-6.
22. Patel KV. Epidemiology of Anemia in Older Adults Semin Hematol 2008;45(4):210-7.
23. Woodman R, Ferrucci L, Guralnik J. Anemia in older adults. Curr Opin Hematol 2005;12(2):123-8. Review.
24. Willems JM, den Elzen WP, Vlasveld LT, Westendorp RG, Gussekloo J, de Craen AJ. No increased mortality risk in older persons with unexplained anaemia. Age Ageing 2012;41(4):501-6.
25. Metivier F, Marchais SJ, Guerin AP, Pannier B, London GM. Pathophysiology of anaemia: focus on the heart and blood vessels. Nephrol Dial Transpl 2000;15(3):14-8.
26. Wu WC, Rathore S, Wabg Y, Radford MJ, Krumholz HM. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 2001;345(17):1230-6.
27. Silverberg DS, Wexler D, Blum M, et al. The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations. J Am Coll Cardiol 2000;35(7):1737-44.
28. Lipschitz D. Medical and functional consequences of anemia in the elderly. J Am Geriatr Soc 2003;51(3 Suppl):10-3.
29. Pickett JL, Theberge DC, Brown WS, Schweitzer SU, Nissenson AR. Normalizing hematocrit in dialysis patients improves brain function. Am J Kid Dis 1999;33(6):1122-30.
30. Beard CM, Kokmen E, O‟Brien PC, An´ia BJ, Melton LJ. Risk of Alzheimer‟s disease among elderly patients with anemia population-based investigations in Olmsted County, Minnesota. Ann Epidemiol 1997;7(3):219-24.
31. Marsh JT, Brown WS, Wolcott D, et al. rHuEPO treatment improves brain and cognitive function of anemic dialysis patients. Kid Int 1991;39:155-63.
32. Balducci L, Ershler W.B, Krantz S. Anemia in the elderly-clinical findings and impact on health. Crit Rev Oncol Hematol 2006;58(2):156-65.
33. Herndon JG, Helmick CG, Sattin RW, Stevens JA, DeVito C, Wingo PA. Chronic medical conditions and risk of fall injury events at home in older adults. J Am Geriatr Soc 1997; 45(6):739-43.
34. Dharmarajan TS, Norkus EP. Mild anemia and the risk of falls in older adults from nursing homes and the community. J Am Med Dir Assoc 2004;5(6):395-400.
35. Gruson KI, Aharonoff GB,Egol KA, Zuckerman JD, Koval KJ. The relationship between admission hemoglobin level and outcome after hip fracture. J Orthop Trauma 2002;16(1):39-44.
36. Marcantonio ER, Goldman L, Orav EJ, Cook EF, Lee TH. The association of intraoperative factors with the development of postoperative delirium. Am J Med 1998;105(5):380-4.
37. Pierelli L, Perillo A, Greggi S, et al. Erythropoietin addition to granulocyte colony-stimulating factor abrogates life-threatening neutropenia and increases peripheral-blood progenitor-cell mobilization after epirubicin, paclitaxel, and cisplatin combination chemotherapy: results of a randomized comparison. J Clin Oncol 1999;17(4):1288-95.
38. Extermann M, Chen H, Cantor AB, et al. Predictors of toxicity from chemotherapy in older patients: a prospective pilot study. Proc Am Soc Clin Oncol 2000;19:617a.
39. Smith RE Jr. Erythropoietic agents in the management of cancer patients. Part 1: Anemia, quality of life, and possible effects on survival. J Support Oncol 2003;1(4):249-59.