Question

A 75-year-old man in long term care. He has been bedbound for longer than six months. His history shows he has cardiac and circulatory problems, exacerbated by his lack of activity.

Compare and contrast the hematologic values of a teen and an elder. You will need to defend your answer using specific facts, data, and other information drawn from the textbook and at least one other supplemental source.

Answer 1

Psychological aging ia a gradual process that involves cell loss & organ atrophy. The amount of red marrow & the number of stem cells decrease with aging. However, there does not appear to be complete depletion even in very old adults. The remaining stem cells maintain their functional capacity to divide, but they decrease in number because they are gradually replaced by non-functional fat cells.

Why older adults are getting cardiac, cirulatocir & other health problems compared to a teenager

Although the older adult is still capable of maintaining adequate blood cell levels, the reserve capacity leads the older adult more venerable to possible problems with clotting, oxygen transport & fighting infection, especially during the period of increased demands. The result is the diminished ability of an older adult to compensate for an acute or chronic illness.

Hematological Difference between elderly & teen

1. CBC Studies

Haemoglobin Level (

Hemoglobin (hb) levels begin to decrease in both men & women after middle age, with the low normal levels seen in the most older people.

Estimates of the precapreva of Anemia in the elderly range from a low of 2% among the upper socioeconomic clay of independently living elderly to a high of 40% among institutionalised elderly. Which will be under normal value in a teenager.

Iron deficiency

Iron deficiency is usually responsible for the low hb level, the cause of anaemia in many older person is unknown. But coming in the case of a teenager we 99% of identification of the reason of the development of Anemia can be done.

Hematopoiesis

Hemopoietic defects in the older adult during illness may vin part be explained by impaired production of growth factors ( erythropoietin etc ) and thus a reduced response of hematopoiesis in illness.Teenagers are under their developmental age, so this mechanism is highly active, which makes them respond quickly to illness.

Iron Absorption

It is not impaired in the older patients, but adequate nutritional intake of iron may be reduced.

It is essential to assess for signs of disease process such as GI bleeding before concluding that decrrdecr hb levels are caused solely by aging. Exception to a malnourished chilC most of the teenager possess a normal iron levels, because the caregivers nourish them with foods with great source of nutrients.

RBC

The osmotic fragility of RBC's is increasing in the older person. Which leads to increase in MCV & decrease in MCHC. Which is not happening in a teen, since he has healthy RBCs.

WBC Count

Not affected by aging. But shows minimal elevation during infection.

These findings suggest a diminished bone marrow reserve of granulocytes in older adults & reflects the possible impaired stimulation of hemopoiesis.

Platelets

Not affected by aging, but changes in vascular integrity from aging can manifest as easy bruising.

Teenagers are under 13 to 19 years, which is coming under the developmental age, so they can maintain a very normal hematological values compared to an elderly.

2. Clotting Studies ( changes in elderly)

PTT	Decreased
Fibrinogen	May be elevated
Factor V, VII, VIII, IX	May be elevated
ESR	Increased significantly

3. Iron Studies ( changes in elderly )

Serum iron	Decreased
Total iron binding capacity	Decreased
Ferritin	Increased
Erythropoietin	May be decreased