PREVALENCE OF ANEMIA IN THE ELDERLY ATTENDED BY THE HEMATOLOGY OUTPATIENT CLINIC OF A TERTIARY HOSPITAL IN THE STATE OF CEARÁ

Abstract

Introduction

Anemia is a notable public health issue, particularly affecting vulnerable groups such as children, pregnant women, adolescents, and menstruating women. In the elderly, it is linked to an increased risk of death, more frequent hospitalizations, susceptibility to falls, reduced muscle strength, and dementia. Anemia is characterized by a reduction in hemoglobin levels and is considered pathological when the indices fall to < 12.0 g/dL in women and < 13.0 g/dL in men. These clinical conditions require appropriate medical attention and an accurate diagnosis.

Objective

To identify the prevalence of the causes of anemia in elderly patients seen at the hematology outpatient clinic of a tertiary hospital in the state of Ceará.

Methodology

We conducted a retrospective observational study based on outpatient records of patients over 60 with anemia. We used an investigation protocol to identify and differentiate the various causes of anemia.

Results

We identified 246 elderly patients with anemia seen at the hematology outpatient clinic, of whom 160 were female and 86 male, with an average age of 74.38 years, with the age group most affected by anemia being 70 to 79 years (n = 100). The main cause of anemia in the elderly at this outpatient clinic was myelodysplastic neoplasm (MDS), accounting for 32.1% of cases (n = 79), mainly affecting the 60-69 age group, and the second leading cause of anemia at this outpatient clinic was Chronic disease anemia (CDA) (n = 78). Nutritional anemia accounted for 21.5% (n = 53), represented by iron deficiency anemia (n = 42) and megaloblastic anemia (n = 11). Anemia due to chronic renal failure (CRF) accounted for 3.3% (n = 8). Other causes of anemia such as hypersplenism, alcoholic liver disease, thalassemia, and hemolytic anemia, among others, accounted for 9.3% (n = 23) of the cases, and other hematological neoplasms other than myelodysplastic neoplasia accounted for 2% (n = 5) of the cases.

Discussion

The findings of this study highlight that MDS are the main cause of anemia in the elderly, corroborating previous studies that have identified this etiology as prevalent in the geriatric population. In addition, CDA also proved to be a significant cause, underlining the need for careful assessment of comorbidities. Nutritional anemia, especially iron deficiency, indicates that iron deficiency is still a significant problem in this population, in line with previous studies highlighting this deficiency in the elderly even in well-developed regions, and suggesting the need for more effective nutritional interventions. The low prevalence of anemia due to CRF, despite the high incidence of kidney disease in the elderly, may reflect adequate management of this condition or a differential focus in diagnosis.

Conclusion

Myelodysplastic neoplasm and anemia from chronic disease are the main causes of anemia in the elderly seen at the hematology outpatient clinic in Ceará. The detection and effective management of anemia in this population requires a comprehensive, multidisciplinary approach.