Iron Deficiency Anemia in the Elderly

Fritz Francois, MD, Gerald A. Villanueva, MD, Edmund J. Bini, MD, FACP, FACG, Division of Gastroenterology, VA New York Harbor Healthcare System, Bellevue Hospital, and NYU School of Medicine, New York, NY.

Iron deficiency anemia is the most common cause of anemia encountered in clinical practice. In elderly patients, iron deficiency anemia is most commonly due to gastrointestinal blood loss, but also can be caused by poor iron intake or malabsorption of iron. Therefore, a careful evaluation of the gastrointestinal tract is warranted in all elderly patients with iron deficiency anemia. Upper endoscopy and colonoscopy can detect clinically important lesions in up to 44-84% of patients. In those who do not have a cause of iron deficiency anemia identified by endoscopy, the prognosis is excellent. Treatment includes iron supplementation and careful monitoring of hemoglobin levels.
Key words: iron deficiency, anemia, endoscopy, gastrointestinal bleeding, iron malabsorption.