Original Research Articles
Morphological and Etiopathological Profile of Anaemia in Older Adults at a Tertiary Care Centre in Upper Assam, India: A Hospital-Based CrossSectional Study
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Keywords:
- Geriatric anemia; Nutritional deficiency; Iron deficiency anemia; Etiopathology; Morphological patterns
Abstract
Background: Anaemia is common in older adults and is associated with functional decline and death, yet hospital-based data from Northeast India remain scarce. This study described the morphological patterns and underlying causes of anaemia in older inpatients at a tertiary care centre in Upper Assam. Methods: In this hospital-based cross-sectional study, 90 consecutive inpatients aged 60 years or older with anaemia (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) were enrolled over 12 months (December 2023 to November 2024). Patients with recent major surgery, transfusion, chemotherapy, radiotherapy or haematinic therapy were excluded. All underwent a complete blood count, peripheral smear examination, iron studies and serum vitamin B12 assay. Severity was graded as mild (haemoglobin >9.0 g/dL), moderate (7.0–9.0 g/dL) or severe (<7.0 g/dL). Proportions are reported with 95% Wilson score confidence intervals (CIs). Results: The cohort comprised 47 men and 43 women (ratio 1.1:1); 57 (63.3%) were aged 60–69 years. Severe anaemia was present in 41 patients (45.6%; 95% CI 35.7–55.8), and mean haemoglobin did not differ across age groups (p = 0.752). Microcytic hypochromic anaemia was the predominant morphological pattern (57.8%; 95% CI 47.5–67.5), followed by normocytic normochromic anaemia (36.7%). Nutritional deficiency accounted for 65.6% of cases (95% CI 55.3–74.6): isolated iron deficiency 48.9%, isolated vitamin B12 deficiency 8.9% and combined iron and vitamin B12 deficiency 7.8%. Anaemia of chronic disease was the second most frequent cause (28.9%). Smear morphology corresponded imperfectly with the final diagnosis: 31.8% of patients with iron deficiency were normocytic, and only 2 of 8 with isolated vitamin B12 deficiency were macrocytic. Conclusions: Iron deficiency was the leading cause of anaemia among older inpatients in Upper Assam, and nearly half presented with severe anaemia. Because smear morphology alone frequently misclassified the cause, biochemical confirmation should be routine. Community-based screening of older adults for anaemia, coupled with appropriate evaluation for the source of iron deficiency, may allow earlier detection and treatment.
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