Hematological Indices, Nutrient Intake and Health Status of Older Adults in Selected Suburban Filipino Community
Julieta Z. Dungca*, Aileen C. Patron, Ma. Cristina S.J. Liwanag,
Charito M. Bermido, Veron Balintona, and Erna V. Yabut
Centro Escolar University, School of Science and Technology & College of
Medical Technology, 9 Mendiola, Manila, Philippines
corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
This study investigated the health status of 90 male and 169 female community-dwelling individuals ≥ 60 yrs in terms of the hematological values, nutritional status and medical history. Hematological test results were obtained using an automated hematology analyzer. Interviews and pretested questionnaires were used to obtain the demographic profile, medical history and nutrient intake based on a 24-hour recall. Based on the WHO criteria of anemia (Hb < 120 g/L for female and < 130 g/l for male), 21.6% were anemic. Of these, 78.6% have normocytic normochromic type, while 10.7% have hypochromic microcytic type. Leukocytosis was observed in 8.1%, eosinophilia in 26%, and lymphocytosis in 7.7% of the participants. Age was found to be inversely correlated with the erythrocyte count (p= but positively correlated with the mean corpuscular volume (p<0.01). Arthritis (36%) and hypertension (29.3%) were the most common health complaints. Inadequate protein, energy and calcium intake were noted in 83.6%, 77.6%, and 91.1%, respectively. Almost all of those who were found anemic had deficiency in iron and thiamine. The findings of high proportion of older adults with abnormal hematological values and deficiencies in major nutrients, may suggest an impaired health status that warrants immediate medical attention. Likewise, the high incidence of anemia with eosinophilia and the very significant correlation between anemia and eosinophil count (p=0.01) may imply helminthic parasitic infection in this group of older individuals which has to be confirmed through fecalysis and allergy tests.
INTRODUCTION
Aging of the world population is anticipated in the next four decades. According to the 2006 Revision of the World Population Prospects, by 2045, there will be more people age 60 years and above than children (World Population Prospects 2006). . . . . . . . . . . . . .
REFERENCES
ALBRIGHT JW, ALBRIGHT JF. 1994. Ageing alters the competence of the immune system to control parasitic infection. Immunol Lett 40(3): 279-85. Philippine Census Data, 2000.
CHOI C, LEE J, PARK KH, YOON SY, CHOI IK, OH SC, SEO JH, KIM BS, SHIN SW, KIM YH, KIM JS. 2004. Prevalence and characteristics of anemia in the elderly: cross sectional study of three urban Korean population samples. Am J Haematol 77: 26-80.
DE GUZMAN MP, NARCISO Z, LARA R, ADRIANO M, MAGSAYSAY C, MAGBITANG J, PEDRO MR. 1996. An assessment of the Nutritional Status of Selected Filipino Urban Elderly. Philipp J Sci 125(1): 69-88.
FERRUCCI L, GURALNIK JM, BANDINELLI S, WOODMAN R, LAURETANI F, CORSI AM, CHAVES P, ERSHLER W, LONGO D. 2007. Unexplained anaemia in older persons is characterized by low erythropoietin and low levels of proinflammatory markers. Br J Haematol 136(6): 849-55.
GASKELL H, DERRY S, ANDREW MOORE R, MCQUAY H. 2008. Prevalence of anemia in older persons. BMC Geriatrics 8:1 doi:10.1186/1471-2318-8-1.
GURALNIK JM, EISENSTAEDT RS, FERRUCCI L, KLEIN HG, WOODMAN RC. 2004. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia Blood 104(8): 2263-8.
HERMALIN A. 2002. The well-being of the elderly in Asia: A four-country comparative study. University of Michigan Press. 648p. In: The American Journal of Sociology. Vol. 109, No. 3 (Nov., 2003), p. 797-800. Review by Bogue, Donald.
HURTADO-GUERRERO AF, ALENCAR FH, HURTADO-GUERRERRO JC. 2005. Occurrence of enteroparasites in the elderly population of Nova Olinda do Norte, Amazonas, Brazil. Acta Amaz 35(4): 487-490.
JHA A. 2006. Anemia is an important predictor of decline and death in community-dwelling elders. J Clin Outcomes Manage 13(5): 259-260.
JUGUAN JA, LUKITO W, SCHULTINK W. 1999. Thiamine Deficiency is Prevalent in a Selected Group of Urban Indonesian Elderly People. J Nutr 129: 366-371.
KOSIBOROD M, CURTIS JP, WANG Y, SMITH GL, MASOUDI FA, FOODY JM, HAVRANEK EP, KRUMHOLZ HM. 2005. Anemia and outcomes in patients with heart failure: a study from the National Heart Care Project. Arch Intern Med 165: 2237-44.
MCPHERSON R, PINCUS M. 2009. Henry’s Clinical Diagnosis and Management by Laboratory Methods. (ed). 21th ed. Singapore. Saunders Elsevier. 1555p.
MOWIE M, BOHMER T, KINDT E. 1994. Reduced nutritional status in an elderly population (> 70 y) is probable before disease and possibly contributes to the development of disease. Am J Clin Nutr 60(2): 298.
NILLSSON-EHLE H, JAGENBURG H, LANDAHL R, SVANBORG S. 2000. Blood hemoglobin declines in the elderly; implications for reference intervals from age 70-88. Eur J Haematol 65: 297-305.
NISSENSON AR, GOODNOUGH LT, DUBOIS RW. 2003. Anemia: not just an innocent bystander. Arch Intern Med 163: 1400-04.
NUCHAPRAYOON I. 1998. Eosinophilia, anemia and parasitism in a rural region of northwest Thailand. Southeast Asian J Trop Med Public Health 29(3): 584-9.
PEDRO MR, BARBA CV. 2001. Nutritional issues and status of older persons of the Philippines: the IUNS, CRONOS and other studies. J Nutr Health Aging 5(2): 92-6.
PENNIX BW, PAHOR M, WOODMAN RC, GURALNIK JM. 2006. Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci 61(5): 474-9.
PHILIPPINE CENSUS. 2007. Available at: http://www.census.gov.ph/data/sectordata/2007/region%203.pdf. 2006(61): 474-479.
RUGGIERO C, METTER E, CHERRUBINI A, et al. 2007. White cell count and cardiovascular mortality white blood cell count and mortality in the Baltimore study of aging. J An Coll Cardiol 2007(49): 1841-50.
SALIVE M, CORNONI-HUNTLEY J, GURALNIK J, PHILIPPS C, WALLACE R, OSTFELD A. 1992. Anemia and hemoglobin levels in older persons: relationship with age, gender, and healthy status. J Am Geriatr Soc 40: 489-96.
SHAKYA B, RAI SK, SINGH A, SHRESTHA A. 2006. Intestinal parasitosis among the elderly people in Kathmandu Valley. Nepal Med. Coll. J. 8: 243-247.
SPIVAK J. 2006. Anemia in the elderly: a growing health concern. Accessed from: www.medscape.com/ viewarticle/522647.
WEISS S, SEGAL M, SPARROW D, WAGER C. 1995. Relation of FEV1 , and peripheral blood leukocyte count to total morbidity; the normal ageing study. Am J Epidemiol 42: 493-498.
WEISKOFF D, WEINBERGER B, GRUBECKLOEBENSTEIN B. 2009. The aging of the immune system. Transpl Int 22(11): 1041-50.
[WHO] World Health Organization. 1968. Nutritional anaemia: Report of a WHO scientific group. World Health Organ Tech Rep Ser 405: 5-37.
WORLD POPULATION PROSPECTS: The 2006 Revision. Available at: http://www.un.org/esalpopulation/publications/wpp2006/FS_ageing.pdf Date Accessed: Feb. 13, 2010.
ZAKAI N, KATZ R, HIRSCH C. 2005. A prospective study of anemia status, hemoglobin concentration and mortality in an elderly cohort: the cardiovascular health study. Arch Intern Med. 165: 2214-20. Accessed February 14, 2010.
