Anemia Evaluation and Management in Nursing Home Residents

Abstract

Anemia is often an unrecognized and/or undertreated diagnosis in older adults. Failure to diagnose anemia leads to delayed treatment and thus delayed relief of symptoms. Given the potentially significant impact of anemia on cardiovascular disease and physical performance among older nursing home (NH) residents, it is important to evaluate current clinical practice related to anemia.The purpose of this secondary data analysis was to evaluate the frequency of laboratory evaluation and medication treatment for anemia among older NH residents. Results indicated that more than half of NH residents were anemic at baseline, and of those, less than 20% had additional testing done to further evaluate for an underlying cause of their anemia and only 45.3% received any pharmacologic treatment. Future research is needed to clarify the potential benefits of timely diagnosis and appropriate treatment for anemic older adults in long-term-care settings and establish evidence-based guidelines to direct care in this area.

Iron Deficiency Anemia in Older Females: A Comparison Between Community-Dwelling Individuals and Nursing Home Residents in the Southwest of Iran

“…In general, age-related physiological changes, reduced food intake, multiple underlying diseases, and inadequate nutritional care are among the main causes of anemia in the elderly (10). According to WHO, 40% -89% of female cases diagnosed with anemia are associated with the iron deficiency, and according to studies, 40% of anemic cases are female elderlies living in nursing homes (11), which inadequate iron intake and/or chronic loss of iron due to gastrointestinal bleeding are the main causes of this complication. In general, among nursing home residents, iron deficiency anemia (IDA) is more related to the loss of blood than lack of nutrients (6,12).…”

“…underlying illness that can affect cardiovascular function, physical activity, mobility and movement, risk of falling, hospitalization, disability, and mortality. In addition, it increases the risk of frailty syndrom, depression, delirium, and cognitive impairment, and affects the quality of life in the elderly (11,(13)(14)(15)(16)(17)(18)(19)(20)(21). In other words, the probability of hospitalization in older patients with anemia living in nursing homes is twice more than that of their peers without this complication (6).…”

Erythropoiesis‐stimulating agents: friends or foes?

“…Any therapeutic intervention carries risks and the risk:benefit ratio in the context of each individual patient should drive the decision. Despite its high prevalence and considerable consequences, anemia remains surprisingly underrecognized and undertreated in many patient populations . This could be a result of a knowledge deficit by clinicians, underestimation of the risks of anemia, perceived high risk:benefit ratio of the available treatments, or a combination of all.…”

“…Despite its high prevalence and considerable consequences, anemia remains surprisingly underrecognized and undertreated in many patient populations. 41,42 This could be a result of a knowledge deficit by clinicians, underestimation of the risks of anemia, perceived high risk:benefit ratio of the available treatments, or a combination of all. In this era of heightened interest in patient safety and cost saving, efforts to choose the right therapy at the right dose for the right condition, the right patient, and the right time in the context of the right comprehensive PBM strategies are essential.…”