Anaemia_in_Elderly.pptx anaemia of chronic diseases

Anaemia in the elderly is always pathological so adequate work up and evaluation is needed to manage elderly patients appropriately

1. Anaemia in the Elderly Professional Academic Presentation Medical Overview

2. Learning Objectives Define anaemia in older adults Understand prevalence & impact Discuss causes and pathophysiology Outline diagnostic approach Review management principles

3. Definition & Epidemiology WHO: Hb <13 g/dL (men), <12 g/dL (women) Prevalence: 10–24% in >65 years Linked with morbidity, mortality, cognitive decline

4. Classification of Anaemia Microcytic → Iron deficiency, chronic disease Normocytic → CKD, chronic disease, marrow failure Macrocytic → B12/folate deficiency, myelodysplasia, drugs

5. Etiology in the Elderly Nutritional deficiencies (iron, B12, folate) Anaemia of chronic disease/inflammation Chronic kidney disease Myelodysplastic syndromes Occult malignancies (esp. GI tract) Drug-related (NSAIDs, chemotherapy)

6. Pathophysiology Reduced erythropoietin response Decreased marrow reserve Chronic inflammation (↑ hepcidin, ↓ iron availability) Nutrient malabsorption (gastritis, PPI use)

7. Clinical Features Fatigue, weakness, dizziness Dyspnea, angina, palpitations Cognitive decline, frailty, falls Masked by comorbidities

8. Diagnostic Workup CBC + indices (MCV, MCH, RDW) Reticulocyte count Iron studies (Ferritin, Transferrin saturation) B12 & Folate levels Renal function (eGFR, creatinine) Bone marrow biopsy if unexplained GI evaluation for occult bleeding

9. Management Principles Treat underlying cause Iron therapy (oral/IV depending on tolerance) B12 & folate supplementation Erythropoiesis-stimulating agents (ESAs) in CKD Blood transfusion (severe/symptomatic cases) Manage comorbidities & frailty

10. Special Considerations Polypharmacy & drug interactions Frailty & functional status Risk–benefit: transfusion vs. ESA therapy Monitor treatment side effects

11. Case Discussion 75-year-old with fatigue & melena Hb 8.5 g/dL, microcytic, low ferritin Colonoscopy → bleeding colonic carcinoma Management → iron correction + oncological referral

12. Summary Anaemia common in elderly; multifactorial Always investigate underlying cause Tailor management to comorbidities & frailty Improves quality of life and reduces morbidity

13. References WHO Guidelines UpToDate Clinical Review Harrison’s Principles of Internal Medicine Recent peer-reviewed articles