Anemia and Older Adults

Am I at Risk?

You may have anemia if you experience any of the following signs or symptoms:

• Weakness
• Shortness of breath
• Pallor (paleness of the skin)
• Dizziness
• Coldness in your hands and/or feet
• Chest pain
• Headache
• Pounding or “whooshing” in your ears

In addition, if you have any of the following chronic conditions, you might be at greater risk for developing anemia:

• Rheumatoid arthritis or other autoimmune disease
• Kidney disease
• Cancer
• Liver disease
• Thyroid disease
• Inflammatory bowel disease (Crohn disease or ulcerative colitis)

The signs and symptoms of anemia can easily be overlooked. In fact, many people do not even realize that they have anemia until it is identified in a blood test.

How Is Anemia Treated?

The treatment for anemia depends on what causes it.

Iron-deficiency anemia is almost always due to blood loss. If you have iron-deficiency anemia, your doctor may order tests to determine if you are losing blood from your stomach or bowels. Other nutritional anemias, such as folate or B-12 deficiency, may result from poor diet or from an inability to absorb vitamins in the gastrointestinal tract. Treatment varies from changing your diet to taking dietary supplements.

If your anemia is due to a chronic disease, treatment of the underlying disease will often improve the anemia. Under some circumstances, such as chronic kidney disease, your doctor may prescribe medication such as erythropoietin injections to stimulate your bone marrow to produce more red blood cells.

Aplastic anemia occurs if your bone marrow stops producing red blood cells. Aplastic anemia may be due to primary bone marrow failure, myelodysplasia (a condition in which the bone marrow produces abnormal red blood cells that do not mature properly), or occasionally as a side effect of some medications. If you appear to have a form of aplastic anemia, your doctor may refer you to a hematologist for a bone marrow biopsy to determine the cause of the anemia. Medications and blood transfusions may be used to treat aplastic anemia.

Hemolytic anemia occurs when red blood cells are destroyed in the blood stream. This may be due to mechanical factors (a leaky heart valve or aneurysm), infection, or an autoimmune disease. The cause can often be identified by special blood tests and by looking at the red blood cells under a microscope. The treatment will depend upon the cause and may include referral to a heart or vascular specialist, antibiotics, or drugs that suppress the immune system.

Talk with your doctor if you believe you may be at risk for anemia. Your doctor will determine your best course of treatment and, depending on your condition, may refer you to a hematologist, a doctor who specializes in blood disorders.

Is Anemia Preventable?

While many types of anemia cannot be prevented, eating healthy foods can help you avoid both iron- and vitamin-deficiency anemia. Foods to include in your diet include those with high levels of iron (beef, dark green leafy vegetables, dried fruit, and nuts), vitamin B-12 (meat and dairy), and folic acid (citrus juices, dark green leafy vegetables, legumes, and fortified cereals). A daily multivitamin will also help prevent nutritional anemias; however, older adults should not take iron supplements for iron-deficiency anemia unless instructed by their physicians.