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Vol. 12, Art. 74 (pp. 887-899)    |    2011       

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Anemia in the elderly. (review)

Dubikaytis O.V., Koloskov A.V.

City Hospital № 26, St.Petersburg

Brief summary

The incidence and prevalence of anemia increase with age. Anemia of chronic disease is the most common form of anemia in the elderly. Distinguish two main groups of anemia of chronic disease: type of rheumatoid arthritis and neoplastic type. In the development of the anemia of chronic disease involved various independent mechanisms. The most well studied mechanism of iron sequestration. Inhibition of erythropoietin production, inhibition of erythroid precursors in the bone marrow and reduced life expectancy of erythrocytes plays an active role in the development of anemia. Iron deficiency is mainly due to chronic blood loss from ulcers, cancer, diverticula, or angiodysplasia. Hepcidin is the central regulator of systemic iron homeostasis. Knockout mice gepsidin production leads to development of hemochromatosis with multiorgan iron overload. Оn the contrary, transgenic mice overexpressing gepsidin die from iron deficiency anemia. Vitamin B12 deficiency should be suspected in all elderly patients with decreased levels of cobalamin below 300 pg / ml. Most frequently this is due to malabsorption of vitamin B12 due to increased gastric pH and reduce the production of pepsin. In the older population, the diagnosis of anemia may be delayed by a number of age-related conditions.


Key words

anemia, elderly, hemoglobin, chronic disease, iron, hepcidin, vitamin B12

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