By Lodovico Balducci, William B. Ershler, John M. Bennett
Anemia within the aged has been safely outlined because the silent epidemic, representing three million humans within the usa elderly sixty five years and older. occurrence and occurrence of this elevate with age. It differs in its etiology, pathogenesis and remedy from anemia in childrens and more youthful adults. Anemia is linked to diminished survival, elevated threat of useful dependence and hospitalization, elevated probability of congestive center failure and degree renal ailment and cognitive problems. nearly 70% of anemia in older members is reversible.
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Anemia and Aging or Anemia of Aging? 1. The CGA at the SAOP: clinical implications Domain Functional status Assessment Performance status (PS) Activities of daily living (ADL): ● Transferring ● Feeding ● Grooming ● Dressing ● Use of the bathroom Instrumental activities of daily living (IADL): ● Use of transportations ● Use of telephone ● Ability to take medications ● Financial management ● Shopping ● Ability to provide to one’s nutrition Clinical implication Dependence in ADL and IADLs: Increased risk of mortality Increased vulnerability to stress Dependence in ADLs: need for a home caregiver Dependence in IADL: need for a caregiver Explore possibility of functional rehabilitation Comorbidity Number of comorbid conditions Comorbidity scales Risk of mortality and vulnerability to stress increases with the number and severity of comorbid conditions Optimal management of diseases may improve patient health and prevent functional decline Geriatric syndromes Dementia (screen) Depression (screen) Delirium Falls (screen for risk of falls) Osteoporosis Dizziness Neglect and abuse Failure to thrive Increased risk of mortality and functional dependence Increased vulnerability to stress Medication may delay dementia, reverse depression and osteoporosis Fall prevention Nutrition Assessment of malnutrition and of risk of malnutrition Malnutrition is associated with increased vulnerability to stress Polypharmacy Number of medications Risk of drug interactions Complications and cost Social support Personal resources Social resources 26 Lodovico Balducci and Matti Aapro Approximately 20% of individuals 70 and older have some degree of malnutrition (18), and many more are at risk for malnutrition, due to lack of appetite, depression, isolation, and inadequate access to food.
At that point, iron-deficient erythropoiesis appears, and that is manifested by the release of iron deficient (hypochromic) reticulocytes into the circulation. If iron-deficient erythropoiesis persists, the hemoglobin begins to fall (anemia) and the MCV will also begin to fall. How Does Iron Deficiency Come About? There are really only two major mechanisms by which iron deficiency occurs. The first is inadequate intake or absorption of iron. 2. Stages in the development of iron deficiency 1. Negative iron balance 2.
For many of the cytokines, the addition of greater than physiologic 4. The Anemia of Chronic Inflammation 53 concentrations of Epo was able to overcome the suppressive effect of the cytokine. This set the stage for understanding the different Epo dose requirements to correct the anemia in some patient groups, such as those with the anemia associated with cancer chemotherapy (9, 10). In vivo, the administration of IL-1 had a similar effect. When a single dose of IL-1 was given to normal mice, there was a nearly 60% reduction in the number of CFU-E in the femur and spleen of the animals (11).
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