In a landmark study recently published in the International Journal of Equity in Health, researchers spotlighted the pressing and often overlooked health challenge of anemia among older adults in India. Utilizing data from wave 2 of the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD), the investigation provides a nuanced exploration of both the prevalence and underlying causes of anemia within this rapidly growing demographic. This comprehensive analysis not only offers critical epidemiological insights but also underscores the intricate interplay of nutritional deficiencies, chronic diseases, and socio-economic factors contributing to the anemia burden.
India, a nation grappling with a burgeoning aging population, faces unique healthcare challenges, including the rising incidence of anemia in older adults. Anemia, characterized by reduced hemoglobin concentrations or red blood cell counts, has far-reaching consequences beyond fatigue and weakness. Among the elderly, it exacerbates cognitive decline, increases susceptibility to infections, and correlates with higher rates of hospitalization and mortality. By interrogating data from LASI-DAD, a multidimensional survey initially designed to assess cognitive health, the researchers unearthed a critical yet underappreciated dimension of geriatric health: the pervasive presence of anemia.
The study’s methodology integrated a robust diagnostic framework combining blood sample analyses, socio-demographic data, and detailed clinical evaluations to quantify anemia prevalence accurately. Employing World Health Organization (WHO) hemoglobin thresholds tailored for age and sex, the researchers identified a strikingly high anemia prevalence, revealing a public health crisis unfolding among Indian older adults. Their approach also allowed for disaggregation by urban-rural residence, socioeconomic status, and comorbidities, providing a granular perspective on anemia’s multifactorial etiology.
One of the study’s revelatory findings was the disproportionate burden of anemia among females compared to males, reflecting persistent gender disparities in nutritional access and healthcare utilization. Iron deficiency emerged as the dominant etiology, exacerbated by dietary insufficiency and parasitic infections prevalent in many rural settings. However, the research also highlighted the significant contribution of chronic conditions such as chronic kidney disease, inflammatory disorders, and malignancies, all of which disrupt erythropoiesis and iron metabolism, compounding anemia prevalence.
Nutritional deficiencies extended beyond iron, implicating vitamin B12 and folate insufficiencies in a substantial subset of patients. This multifaceted nutritional deficiency pattern points to the inadequacy of current public health interventions that focus predominantly on iron supplementation, urging a more holistic nutritional strategy to ameliorate anemia in the aging Indian population. Furthermore, the study elucidated socio-economic determinants strongly associated with anemia, including poverty, illiteracy, and limited healthcare access, which collectively create barriers to early diagnosis and effective treatment.
The interplay between anemia and cognitive decline formed a central focus of the LASI-DAD survey, linking hematologic and neurological health in a novel framework. Anemia’s role in cerebral hypoxia is hypothesized to accelerate neurodegenerative processes, intensifying the risk of dementia and cognitive impairment. By cross-referencing anemia status with standardized cognitive assessments, the research delineated a correlation that signals an urgent need for integrated screening protocols targeting both hematologic and cognitive disorders in geriatric care.
This study also shed light on the geographical heterogeneity of anemia prevalence, with pockets of alarmingly high rates in specific states marked by endemic poverty and limited healthcare infrastructure. These findings invoke policy considerations for targeted regional interventions, including community-based nutritional programs, enhanced primary care services, and tailored health education campaigns aimed at vulnerable populations. Importantly, the research underscores how anemia in older adults is not merely a medical issue but a social equity concern that mandates multi-sectoral collaboration.
In addressing anemia’s complex etiology, the researchers emphasized the value of diagnostic differentiation—distinguishing between nutritional anemia, anemia of chronic disease, and unexplained causes through advanced laboratory markers. Such precision medicine approaches are vital for devising effective therapeutic regimens, ranging from micronutrient supplementation to management of underlying chronic diseases. The study advocates for integrating anemia screening into routine geriatric assessments to facilitate early detection and bespoke interventions.
The specter of anemia in older adults extends beyond individual health, impacting economic productivity and healthcare costs. The study’s projections caution that without urgent intervention, anemia-related morbidity will compound the strain on India’s healthcare system, already stretched by the dual burden of communicable and non-communicable diseases. Thus, this research amplifies calls for policy frameworks that prioritize geriatric health within national agendas, including the scaling up of nutritional support programs and health infrastructure investments.
The LASI-DAD data’s longitudinal design opens avenues for future research to monitor anemia trends over time and assess the effectiveness of policy measures aimed at its mitigation. Prospective studies can delve deeper into causal pathways, genetic predispositions, and interactions between anemia and other aging-related conditions. Moreover, this dataset offers a foundation to explore anemia’s psychosocial impacts and its relationship with quality of life, enhancing holistic geriatric care paradigms.
This comprehensive examination of anemia among India’s elderly is a clarion call for heightened scientific attention and public health action. With the country poised on the brink of a demographic transformation, understanding and addressing anemia’s multifactorial causes can substantially improve health outcomes, reduce disparities, and foster healthier aging trajectories. Interdisciplinary collaboration among hematologists, gerontologists, nutritionists, and policymakers will be paramount in translating these findings into impactful interventions.
The study’s implications transcend India, offering critical lessons for other low- and middle-income countries navigating similar demographic shifts and health challenges. It underscores the necessity of integrating anemia surveillance into aging research globally and adopting context-specific strategies addressing nutritional insufficiencies and chronic disease management. As the global population ages, anemia’s neglected burden demands recognition as a priority within the framework of healthy aging initiatives.
In conclusion, this groundbreaking research from the LASI-DAD study enriches our understanding of anemia’s prevalence and causative factors among older Indian adults. It challenges existing health paradigms and prompts a reimagining of anemia from a simple nutritional deficiency to a complex multifactorial syndrome intricately tied to aging biology, social determinants, and healthcare inequities. Addressing anemia holistically will be key to unlocking healthier, more equitable aging futures for millions.
Emerging from this work is a compelling narrative that anemia is more than a clinical diagnosis—it is a marker of systemic failure and an opportunity for transformative public health interventions. By harnessing data-driven insights and fostering collaborative, inclusive approaches, stakeholders can substantially reduce anemia’s toll and boost the vitality of India’s aging population. The findings propel the global conversation forward on equitable health strategies that honor the dignity and potential of older adults worldwide.
As researchers continue to dissect LASI-DAD’s rich dataset, the hope is that these detailed revelations catalyze committed action, innovating care models and inspiring a recalibration of health priorities to encompass anemia’s intricate burdens. In doing so, science and policy can forge pathways toward resilient health systems that empower older adults to thrive with strength, clarity, and dignity.
Subject of Research: Prevalence and causes of anemia among older adults in India
Article Title: Prevalence and causes of anemia among older adults in India: findings from wave 2 of the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD)
Article References:
Dhankhar, A., Khobragade, P., Chopra, G. et al. Prevalence and causes of anemia among older adults in India: findings from wave 2 of the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD). Int J Equity Health 24, 315 (2025). https://doi.org/10.1186/s12939-025-02671-4
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