Anemia is commonly seen with increase in the age of the population. In elderly patients, anemia of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life. Iron deficiency is frequently seen in elderly, Vitamin B12¹

The percentage of marrow space occupied by the hematopoietic tissue declines from 90% at birth to a level of approximately 50% at age 30 years and 30% at age 70 years. ²

Anemia is defined as a reduction in the hemoglobin concentration of the blood below normal for age and sex. WHO criteria: Haemoglobin <12 gm/dl in women and <13gm/dl in men.

The UN agreed cut off to refer to the older population is 60+ years. ³

The prevalence of anemia increases with advancing age. In Indian population the prevalence varies between 6% and 30% among males and 10% and 20% among female.

Morphologic classification subdivides anemia into:

One of the largest surveys, that is the third US National Health and Nutritional Examination Survey (NHANES 111), indicated that 10.2% of women and 11% of men > 65 years of age were anemic. ⁴

Sathiya Narayanan S et al., study on geriatrics highlighted that prevalence of anemia among elderly is high in rural areas and often they are under reported, so routine screening for anemia and to know appropriate underlying etiology for the same is recommended. ⁵

All men and women aged 60 years and above.

The present study includes 400 elderly patients aged 60 years and above conducted in the Department of Pathology, Karnataka Institute of Medical Sciences, Hubballi.

The present study showed male predominance of about 58.25% (233) cases majority of cases between age group 60-69 years (237 cases) with and females population comprised around 41.75% (167) cases (Figure 1).

In the present study mean haemoglobin (Hb) is low in 8^th decade (10.82) and 4 cases in 9^th decade showed minimum Hb of 8.7 gm% (Figure 2).

Geriatric anemia is a risk factor for many clinical conditions and its poor outcome, elderly females are commonly affected. Decreased Hemoglobin concentration is a powerful prognostic marker for multiple adverse outcomes in the elderly group. Anemia in elderly will be seen in coexistence with other disease. The study of different morphological patterns of anemia on peripheral blood smear also helps in guiding etiology of anemia. Our study found normocytic normochromic as the common pattern of anemia.

The present study found that maximum cases were between 60-69 years, which was also concurrence with the other studies done by Aithal et al. and Mathew et al. (Table 3).

The present study has got maximum male population 233 cases and females were 167 cases which was similar to many other studies done by Bach et al. and Gangadharan et al. But study done by Sgnaolin V et al. showed maximum female patients (Table 4).

Mean haemoglobin was found to be low in geriatrics in the present study, which was consistent with other studies. Reduced haemoglobin in the elderly population is associated with many other comorbidities (Table 5).

Grading of anemia helps in the prediction of outcome and therapeutic intervention among the patients. The present studies observed that majority of the geriatrics belong to mild degree of anemia (Table 6).

In the present study most common pattern was Normocytic Normochromic anemia (NNA) 75% followed by microcytic hypochromic anemia (MHA) 18%.

Vandana Gangadharan et al. ⁸ study showed that maximum cases 59% were between 60-69 , with male predominance of 54% showed grade one type of mild anemia in 40% of cases showing predominance of Normocytic Normochromic anemia. The present study also showed maximum cases of 59.25% between 60-69years with male predominance 58.25% having mild degree of anemia 69.25% having Normocytic Normochromic anemia pattern on the peripheral blood smear 75% cases (Table 7).

Guralnik JM et al. ¹⁵ study also showed that unexplained/asymptomatic cause for the geriatric anemia was the major symptom which is also seen in the present study (Table 2).

India is a developing country, prevalence of anemia are more common probably because of low socioeconomic status or lack of knowledge about nutrition. The study concludes that diagnosing different morphological patterns of geriatric anemia and its clinical correlation helps in reducing the morbidity and mortality of geriatrics related to anemia and also facilitates the clinicians to improve the treatment protocols and prophylactic therapy.