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October 24, 2005

Anemia in the ElderlyTime for New Blood in Old Vessels?

Arch Intern Med. 2005;165(19):2187-2189. doi:10.1001/archinte.165.19.2187

This issue of the ARCHIVES features 4 articles on anemia, 3 of which focus on its impact in the elderly and the fourth on its role in quality of life. The editorial decision to publish these articles as a group was timely and appropriate. In the United States, there are currently 35 000 000 people 65 years or older, of whom approximately 10% are anemic, and it is estimated that the number of elderly will double by the year 2030. Because the prevalence of anemia, like that of other hematologic disorders, increases with age,1 substantial expansion of the oldest segment of our population has profound implications for public health and preventive and restorative medicine. Anemia, of course, can no longer be considered as merely a disease marker. Rather, it appears to have an independent deleterious influence on disease-related morbidity, mortality, and quality of life.2 Furthermore, although blood transfusion is safer than ever, recent experience with the West Nile virus and blood-borne prion transmission indicates that our blood supply will always be under attack by pathogens. Fortunately, with the development of recombinant human erythropoietin, bloodless medicine is no longer an oxymoron, but recent clinical trials of this hormone in patients with end-stage renal disease3 or cancer4,5 suggest that we have much more to learn about its use.

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