Journal: Anemia in the Long-Term Care Setting

Reasoning:

• High prevalence of anemia among residents in long-term care setting
• This patient was possibly anemic due to ulcers or due to another underlying issue

Purpose:

• The purpose of this article is to review the prevalence, diagnosis, association of anemia with other adverse events, and treatment of anemia in the long-term care setting
• To determine which patients require formal evaluation and treatment for anemia

Key Points:

• Anemia has been associated with cognitive impairment, frailty, renal disease, heart failure, bleeding/nutritional issues, increased risk of falls
• People 65+ are projected to double from 46 million in 2014 to 98 million in 2060 (~1/4 people)
  • People 85+ are projected to triple from 6 to 20 million
• Prevalence of anemia is highest in nursing home residents 47%, as compared to community dwellers 12%
• Anemia is often undiagnosed or its symptoms (fatigue, lethargy, weakness, SOB) are attributed to other conditions
• Previous studies associated anemia with worsening delirium, dementia, overall lower quality of life
  • Also associated with falls, decline in physical performance, and increased mortality
• Evaluation should assess nutritional history, longitudinal weight record
• Need to take into consideration who needs more thorough workup and what is tolerated by the patient
• Treatment involves patient wishes, goals of care, improvements in QOL
  • Asymptomatic long-term care residents vs. acute blood loss from GI bleed

Conclusion:

• Anemia is often overlooked in the long-term care setting and under diagnosed
• Due to the high prevalence of other co-morbidities, detection of anemia is important and will guide appropriate diagnostic and treatment management

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