Aging & Health A to Z
Causes & Symptoms
Symptoms of anemia can include:
- Shortness of breath
- Pale skin color
- Feeling cold
- Behavioral changes, such as lack of interest, confusion, agitation, or depression
If you have heart disease and anemia, you may notice an increase in chest pain or swelling in your ankles.
Since all these symptoms above can also be caused by other problems, you’ll need a physical examination and blood tests to determine whether you have anemia. Sometimes a person may not notice any symptoms, but anemia will be identified by an abnormal result on a routine blood test (such as a blood test that is part of your annual check-up).
Even mild anemia can lead to a lower quality of life. For example, a little muscle weakness and frailty combined with a little less balance can increase the risk of a fall, which would have a major impact on quality of life.
Causes of Anemia
The three major reasons why anemia can happen are described below. In older people, anemia is often the result of more than one condition occurring at the same time. These conditions can include:
- Decreased red blood cell production due to:
- Problems with bone marrow function
- Chronic diseases or inflammation, such as cancer or infections
- Hormone problems
- Kidney disease
- Malnutrition and dietary deficiencies in iron, vitamin B12 or folic acid (folate)
- Hereditary disorders
- Alcohol dependency
- Loss of blood from:
- stomach irritation from medications, alcohol, or an ulcer
- polyps or tumors in the bowels
- kidney stones or tumors
- Increased destruction of red blood cells due to:
- A hereditary disorder
- A disease of your immune system
- Heart valve problems (which damage your red blood cells)
- A tumor
In older adults, the most common causes of anemia are:
A common cause of iron-deficiency anemia is chronic blood loss, usually from the gastrointestinal tract. Bleeding ulcers or polyps, chronic irritation of the lining of the gastrointestinal tract, or cancer can cause this kind of “silent” internal bleeding. Often, this blood loss is invisible to the naked eye, and your healthcare provider may do a simple test, called a fecal occult blood test, to find it.
Anemia of Chronic Disease
Anemia of chronic disease can result from chronic inflammation caused by ongoing infections, tissue damage, various forms of arthritis, benign or malignant tumors, or a variety of chronic medical conditions. These conditions cause inflammation inside your body and prevent your bone marrow from working as well as it should.
Anemia of B12 and Folate Deficiencies
Vitamin B12 and folate (folic acid) are two vitamins important for red blood cell production. Vitamin B12 deficiency is more common with advancing age, particularly in women over the age of 60 and adults with autoimmune thyroid disease. Signs and symptoms include:
- General body weakness
- Pale skin
- Changes in the nervous system (some signs of this include a clumsy walk, or numbness and tingling in the arms and legs)
- Behavioral changes or confusion
Folate deficiency can result from poor nutrition, certain medications, or diseases affecting absorption from the gut.
Anemia caused by red blood cell destruction is called hemolytic anemia. Problems with your immune system are often to blame. Cancers, such as non-Hodgkin's lymphoma or chronic lymphocytic leukemia, also destroy red blood cells. Hemolytic anemia can also be caused by medications or infections, or by an immune system disease like rheumatoid arthritis or lupus.
Updated: November 2016
Posted: March 2012