ANAEMIA AMONG ELDERLY INPATIENTS: CLINICOPATHOLOGICAL SPECTRUM AND CHARACTERISTICS OF UNEXPLAINED ANAEMIA
Hardik Jain*, Purvi A. Trambadiya, Sudha Jain, Gunjan Gandhi
ABSTRACT
Background: Anaemia in older adults is common, clinically important, and often multifactorial. A proportion of
patients remain without an identifiable cause despite evaluation and are classified as having unexplained anaemia.
Objective: To describe the clinico-haematological profile, morphological patterns, aetiological spectrum, and
diagnostic implications of anaemia in elderly hospitalised patients, with special emphasis on unexplained anaemia.
Methods: This hospital-based observational study included 367 elderly inpatients (≥60 years) with anaemia at a
tertiary care teaching hospital in South Gujarat. Clinical findings, complete blood count, peripheral smear,
reticulocyte count, iron studies, vitamin B12 and folate levels, renal and liver function tests, and other relevant
investigations were reviewed. Unexplained anaemia was diagnosed after exclusion of identifiable causes. Results:
The mean age was 68.48 ± 7.46 years and 59.9% were male. Moderate anaemia was most common (54.2%).
Normocytic normochromic morphology predominated (40.33%). Iron deficiency anaemia was the leading
identifiable cause (17.98%), followed by anaemia of chronic disease (13.35%), unexplained anaemia (12.81%),
and vitamin B12 deficiency (12.53%). Among unexplained cases, 40.43% were aged ≥80 years, 82.98% showed
normocytic morphology, and 76.60% had reticulocyte counts of 1–2%. Conclusion: Anaemia in elderly inpatients
is heterogeneous and frequently multifactorial. Unexplained anaemia accounted for 12.81% of cases and was
characterised by advanced age, normocytic morphology, and limited reticulocyte response, highlighting the need
for structured evaluation and follow-up.geriatric anaemia, unexplained anaemia, normocytic anaemia, reticulocyte count, elderly.
Keywords: geriatric anaemia, unexplained anaemia, normocytic
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