How I Treat Anemia in Older Adults.

With the growing older adult population around the world, clinicians face the common, yet complex challenge of how to evaluate and manage anemia in this population. Older age predisposes to common causes of anemia- nutritional deficiencies, inflammatory disorders, chronic kidney disease, and hematologic malignancies. Failure to diagnose and appropriately manage anemia may result in decreased quality of life, impaired cognition, impaired mobility, and increased mortality. Anemia diagnosis in older adults presents a diagnostic conundrum as anemia may have a single cause, may be multi-factorial, or may have no apparent cause even after an extensive evaluation. We believe a systemic approach to diagnosis ensures appropriate testing and avoids the pitfall of under and over-treatment. In this article we present our recommended approach through common scenarios for the management of anemia in the older adult.