Literally speaking, anemia means poor and insufficient blood, but in reality it mainly refers to the reduction of red blood cell hemoglobin content. According to our hematologists, hemoglobin (often expressed as Hb on the checklist) <120 g/l for adult men and <110 g/l for adult women (non-pregnant) is considered anemia. In contrast, the World Health Organization (WHO) defines anemia in people over 65 years of age as hemoglobin <130 g/L for men and <120 g/L for women. In the whole population of anemia, the prevalence is higher in women than in men. However, in elderly anemia, men are higher than women.
In addition, anemia in the elderly has the characteristic of being both serious in consequences and often neglected.
Anemia in the elderly can aggravate other diseases
Red blood cells supply oxygen to tissues and cells throughout the body and carry away some of the carbon dioxide produced. Therefore, a decrease in the number of red blood cells (or hemoglobin content) can directly cause a decrease in the function of the body’s organs, leading to pathologies. Elderly people, especially those with chronic diseases, are already in a state of oxygen deprivation, and if anemia occurs again, their existing chronic diseases will be aggravated.
Anemia, which can be self-monitored
The clinical manifestations of anemia in the elderly have some special characteristics compared to the general population. For example, the general anemia “observation of color (pale skin, dark eyelids, lack of redness of oral mucosa, etc.)” is not very suitable for the elderly. With age, the elderly often have various physiological signs of aging, such as skin folds, pale color or pigmentation, redness of eyelid conjunctiva due to inflammatory congestion, and distortion of gum color due to denture, which also affects the accurate determination of oral mucosa color.
The elderly themselves can suspect anemia by the following symptoms –
General manifestations: weakness, emaciation, loss of energy, pale or yellow face, ankle edema, etc.
Cardiovascular system manifestations: palpitations, shortness of breath, chest tightness, breath-holding, etc. If the elderly have coronary heart disease with anemia, angina may be triggered, and those with severe anemia may have cardiac insufficiency.
Neurological manifestations: such as indifference, confusion, hallucinations, excitement, delusions, insomnia, urinary and fecal incontinence, etc., which can be easily misdiagnosed as geriatric psychosis. These symptoms are mostly associated with cerebral atherosclerosis in the elderly.
Digestive system manifestations: decreased appetite, even nausea, vomiting, etc.
If you have any of these symptoms, you can go to the hospital for blood tests to confirm the diagnosis.
Anemia 3 causes: diet, disease and medicine
1, nutritional factors: including iron, vitamin B12, folic acid and other deficiencies. In recent years, in order to prevent hypertension, coronary heart disease, diabetes and other “modern civilization diseases”, many people have taken improper dietary restrictions. For example, a simple vegetarian diet with very low protein and fat intake. In addition, as the elderly age, teeth fall out, taste buds atrophy, and gastrointestinal function decreases, which inevitably affects the digestion and absorption of nutrients, leading to a lack of hematopoietic materials, resulting in insufficient production of red blood cells or hemoglobin. Older people have less stomach acid so that the absorption of iron is reduced, prone to iron deficiency; strong tea drinkers, especially those who drink tea after meals, the tannic acid in tea can be combined with iron to affect iron absorption.
2, disease factors: chronic infections, rheumatic diseases, kidney lesions, malignant tumors, blood diseases, etc. can lead to anemia. There are two points worth pointing out: one is malignant tumor, and the other is blood disease.
Among malignant tumors, digestive tract tumors and hematopoietic cell tumors are common. Gastrointestinal tumors such as gastric cancer, esophageal cancer and colon cancer can lead to anemia, especially iron deficiency anemia, due to long-term chronic blood loss or acute hemorrhage in small amounts. Therefore, for elderly men or postmenopausal women, once the manifestation of iron deficiency anemia appears, the cause must be traced, especially to exclude digestive tract tumors.
Hematopoietic cell tumors such as leukemia, myelodysplastic syndrome, and multiple myeloma are common in the elderly, and the incidence of acute granulocytic leukemia increases with age after age 65. The annual incidence of myelodysplastic syndromes is much higher in the age group of 70 to 79 years than in those younger than 50 years. There is also multiple myeloma, which has an insidious onset and sometimes has anemia as its first manifestation, and is often misdiagnosed as a result.
3. Drug factors: Elderly people often suffer from chronic diseases such as hypertension, coronary heart disease and diabetes, which require long-term medication. The most commonly used anti-platelet aggregation drugs, such as small doses of aspirin, can cause anemia in about 2% of patients due to gastrointestinal blood loss with long-term application. In addition, cyclophosphamide, azathioprine, methotrexate, and interferon can cause anemia through bone marrow suppression, so be vigilant when using the drugs. Certain drugs such as non-steroidal anti-inflammatory drugs (indomethacin, naproxen, diclofenac, etc., which are widely used clinically for osteoarthritis, rheumatoid arthritis, many kinds of fever and relief of various pain symptoms), β-lactam antibiotics (cephalosporin, amoxicillin, etc.), and anti-tuberculosis drugs (isoniazid, etc.) can also cause anemia.
Diet is the first choice to prevent anemia at home
Elderly people who are taking medication should follow the doctor’s instructions to take the medication correctly. If the drug has adverse effects that cause anemia, you should have regular blood tests and make a conscious effort to replenish blood through diet. If you have a disease that predisposes to anemia, you should treat it actively and treat it prophylactically under the guidance of your doctor. Here, we focus on the dietary approach to prevent and treat anemia.
Principles: nutritious, comprehensive and balanced; more natural, less processed; less food, more meals, easy to digest; appropriate for each person and each time depending on the disease. Avoid contact with toxic physical, chemical and biological factors; strengthen labor protection; use medication under the guidance of a specialist; etc.
1, blood food can be appropriate to eat more
Usually, you should eat more iron-rich food, and do not drink strong tea after meals. Secondly, some drugs that neutralize stomach acid will hinder the absorption of iron, try not to eat with iron-containing food. In addition, supplement high-quality protein and vitamin B12 and folic acid. Protein is an important raw material for constituting hemoglobin. Patients with anemia should consume enough protein, such as milk, lean meat, fish, eggs, soybeans and soy products. Fresh green vegetables, fruits, melons, beans and meat are rich in folic acid; meat and viscera such as liver, kidney and heart are rich in vitamin B12.
Foods with high iron content and aids in iron absorption
(1) Iron-rich animal foods include lean animal meat, blood (blood tofu), liver, kidney, tongue, etc., as well as duck gizzard, squid, jellyfish, shrimp, egg yolk, etc.; plant foods include sesame, kelp, black fungus, nori, hairy vegetables, shiitake mushrooms, soybeans, black beans, bean curd, celery, capers, dates, sunflower seeds, walnuts, etc.
(2) Eat more foods rich in vitamin C, such as fresh green leafy vegetables and fruits, to promote the absorption of iron in the intestine.
(3) Be aware that vegetable fiber can affect the absorption of iron, so iron supplementation with animal sources is best.
2.Avoid single diet
Patients with anemia often have poor appetite and indigestion, therefore, special attention should be paid to the color, aroma, taste and shape of the diet to arouse the patient’s appetite. Always eating the same food every day should be avoided. Too monotonous food will not only cause anorexia over time, but also lead to certain vitamin deficiencies and aggravate the degree of anemia. Therefore, try to use a variety of food in the main food and side dishes. When making dishes, you should always change the style, for example, in addition to rice and noodles, the main food should be mixed with some beans, millet, corn and so on. Side dishes such as lean meat, fish, shrimp, animal offal, soybean products, various green leafy vegetables, etc. should be frequently changed for consumption, which can not only stimulate the patient’s appetite, but also make the vitamins between the foods complement each other, improve the value of food, and help correct anemia.
3.Eat more food that is easy to digest and absorb
Patients with anemia often have symptoms such as loss of appetite and indigestion, therefore, zinc preparations and digestive enzyme yeast tablets can be appropriately supplemented to promote appetite and digestion and absorption. In addition, elderly people who have lost their teeth or suffer from chronic gastrointestinal diseases, etc. lead to poor digestion. When cooking, try to make meals as soft as possible, and consume minced meat, liver puree, vegetable puree, minced vegetables, steamed egg custard, and also eat tofu and tofu brain frequently in order to comprehensively absorb the various essential substances provided. To reduce the gastrointestinal burden of anemic patients, spicy and cold foods should not be eaten. At the same time, it is also necessary to eat less and more meals, and it is advisable to lie down for 30 minutes after meals to promote digestion.
4. Pay attention to the cooking method to minimize vitamin loss
In order to make the patient’s body use more vitamins, scientific cooking methods should be used to preserve the nutrients in food as much as possible. When making staple foods, do not overdo the rice panning, do not rub the rice by hand when washing, and do not put alkali in the porridge when cooking. When making side dishes, buy fresh vegetables, preferably buy and make them now, and wash and cut the vegetables first, then stir-fry them immediately after cutting, and avoid overcooking them.
In conclusion, anemia in the elderly is more insidious and has more serious consequences. Therefore, in addition to early hospital checkups if there is a suspicion, regular medical checkups can also help detect anemia early. Early treatment of anemia is not only more effective and less costly, but also minimizes the adverse effects caused by anemia.