Anemia in postmenopausal women: dietary inadequacy or nondietary factors?

i m t w m g c i c b s 8 o c Anemia is a state in which a deficiency in the size, number, and hemoglobin concentration of an erythrocyte exists, impairing oxygen and carbon dioxide xchange between the blood and body tissues (1). The orld Health Organization has defined anemia in women s hemoglobin concentrations less than 12.0 mg/dL (2). p to the age of 75 years, women are disproportionately ffected by anemia, and the prevalence in females 65 ears of age and older in the United States is approxiately 10% (3,4). The manifestation of anemia in older populations is ssociated with dietary inadequacy of micronutrients uch as iron, folate, and vitamin B-12; blood loss; genetcs; alterations in the bioavailability of micronutrients ue to disease or medication use; renal insufficiency; and ther less common causes (3,4). Iron deficiency is the ost common cause of anemia, whereas anemia as a onsequence of vitamin B-12 or folate deficiency is comaratively rare in older adults (5,6). Iron-deficiency aneia is associated with small (microcytic), hemoglobineplete, erythrocytes and is linked to several adverse linical outcomes in adults, including fatigue, decreased ork capacity, palpitations, and alterations in immune unction (7). Megaloblastic anemia is associated with oth late-stage folate and vitamin B-12 deficiency and is videnced by altered nucleoprotein production adversely mpacting both erythrocyte morphology (macrocytic) and aturation (megaloblasitc) (8). Folate and vitamin B-12 eficiency are clinically similar in their presentations in hat both are associated with fatigue, diarrhea, memory oss, and reductions in weight (8). Vitamin B-12 defiiency is also associated with neurological changes. learly, understanding the etiology of anemia in older eople is critical to improving quality of life and decreasng morbidity and mortality in this segment of the popuation and should be a public health priority.