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By Lodovico Balducci, William B. Ershler, John M. Bennett

Anemia within the aged has been appropriately outlined because the silent epidemic, representing three million humans within the usa elderly sixty five years and older. prevalence and incidence of this elevate with age. It differs in its etiology, pathogenesis and therapy from anemia in childrens and more youthful adults. Anemia is linked to lowered survival, elevated probability of useful dependence and hospitalization, elevated danger of congestive middle failure and degree renal illness and cognitive issues. nearly 70% of anemia in older contributors is reversible.

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In older age iron deficiency may have other causes, including decreased absorption of iron, due to gastric achylia, and to increased circulating concentrations of hepcidin. Hepcidin prevents the absorption of iron from the duodenum, and is a protein synthesized in the liver, whose production is stimulated by IL-6 (37) A recently recognized cause of iron deficiency is H Pylori gastritis (38). In some older individuals the secretion of erythropoietin and the erythropoietic response to erythropoietin may be impaired, as a result of increased circulating concentrations of IL-6 and other inflammatory cytokines (39, 40).

4 µmol/mL in the absence of renal failure or folate and B6 deficiency. However, as pointed out by Solomon, there is considerable uncertainty about the diagnostic criteria and probably no one single laboratory value is sufficient (11). 6 (from 10). Food cobalamin malabsorption is characterized by the inability to release cobalamin from food or from intestinal transport proteins, particularly in the presence of hypochlorhydria. This syndrome is defined by the presence of cobalamin deficiency despite an adequate diet.

Vitamin B12 and iron deficiencies frequently coexist and, in some patients, may have a common pathogenesis in H. pylori infection. Diagnostic testing may not be infallible and, again, if there is doubt, one should always treat the patient, because the consequences of not treating B12 deficiency may have significant and irreversible consequences for the patient. References 1. Guralnik, JM, Eisenstaedt, RS, Ferrucci, L, et al. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia.

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