Common But Undertreated: Webinar Addresses Anemia in the Elderly

August 15, 2018
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Anemia is a common problem in post-acute and long-term care (PALTC) that often gets ignored or dismissed. T.S. Dharmarajan, MD, MACP, AGSF, wants to change that. “Anemia isn’t an illness, rather an indicator of an underlying disorder. It is a common problem that will not get better on its own. If you identify anemia, more than likely you can fix it. If you ignore it, it may get worse and result in a fall or other problem.” He will address this and much more during his Society webinar on “Anemia in the Elderly: Evaluation, Outcomes and Management,” set for August 22.

During his 90-minute presentation, Dr. Dharmarajan will offer information about the etiology of anemia and a simple approach to evaluation and management. He will address the adverse outcomes of untreated anemia in this patient population, and he will present four case studies for discussion.

Normal hemoglobin for patients is 12-13, says Dr. Dharmarajan; and if the number gets a little below that—for example, just to 11—this should send up a red flag. He explains, “It may seem like the patient is just a little anemic and that it’s nothing to worry about; but if my hemoglobin was 11, I wouldn’t sleep well. For any abnormal number, you need to find out ‘why.’” Don’t wait until it drops to 8 or 9, he cautions. “A fall is 80-100% more likely in patients with low hemoglobin. There are other consequences as well, such as fatigue, a negative impact on cognition, and worsening of cardiac, brain and/or kidney function,” Dr. Dharmarajan notes. Not only does this affect the person’s health and quality of life, it also can lead to hospitalizations and readmissions.

“The lower the hemoglobin, the more likely the patient will go to the hospital. In most cases, he or she will get a transfusion and feel better for a while. But if you don’t address the etiology and underlying cause, the patient will come back to the hospital in a matter of time for the same condition. You need to break this cycle,” Dr. Dharmarajan says. “I hope to drive home this point in the webinar. There is a domino effect if anemia isn’t addressed. It will lead to other consequences and start a chain reaction.”

Why do older people become anemic?   Dr. Dharmarajan says that based on National Health and Nutrition Examination Survey (NHANES) data, one-third of anemia cases are due to nutrient deficiency, specifically, iron, folate or B-12, or a combination of these. “This nutritional anemia is very easily correctible,” he observes. Another third of anemia cases are caused by illnesses such as chronic kidney disease, and chronic inflammation such as a non-healing pressure ulcer or osteomyelitis.  Anemia in all these cases is treatable to a large extent, but Dr. Dharmarajan stresses that anemia must be identified and the underlying cause diagnosed first. He notes that, for the most part, evaluation “doesn’t cost a fortune,” and you actually may get an answer with a basic workup.

Dr. Dharmarajan hopes that his presentation will help participants feel empowered to address anemia. “I think they will be pleasantly surprised to learn that nearly two-thirds of all cases of anemia can be easily diagnosed and managed,” he says. Webinar attendees couldn’t ask for a more knowledgeable expert on this topic. Dr. Dharmarajan has written and spoken about anemia for several years, and his passion shines through in every word. He says, “I believe that you should give 100% to everything you do. In the end, you hope that you’ve had an impact.” He invites webinar participants to bring a brief summary (3-4 sentences) of cases they have questions about that he can discuss with the group.

No one who knows Dr. Dharmarajan questions his knowledge…or his passion for the Society. “I always enjoy doing things for the organization. When someone from the Society calls and needs me to write, speak or work on a project, I almost always say ‘yes.’ When they asked if I would do a webinar, I actually said that I would do two.” He will be presenting on “Percutaneous Endoscopic Gastrostomy (PEG): Ethical Aspects and Outcomes” later this year.

Click here for more information or to register for the August 22 webinar. As always, registration is free for Society members.