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Copper Deficiency Anemia in Older Patients with Swallowing Disorders: A Case Report


Kazutaka Tanabe1, Keiko Iwaisako2*


1Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 6068507, Japan
2Department of Medical Life System, Faculty of Life and Medical Science, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe city, Kyoto 610-0394 Japan

Corresponding Author Email: kiwaisak@mail.doshisha.ac.jp


Abstract:

Background: Trace element deficiency is most commonly a result of long-term intravenous nutrition; however, it can also develop on rare occasions in people who are fed orally. The present study aimed to investigate the development of copper-deficiency anemia in older patients who were provided with dysphagia diets because of swallowing disorders. Methods: The study included 34 patients who were provided with dysphagia diet A for at least three months at Higashiyama Sanatorium for the Elderly in Kyoto, Japan. Results: Six patients had hemoglobin levels below 10.0 g/dL before being placed on a dysphagia diet; however, this number increased to 17 during this study. Univariate analysis showed the factors associated with anemia onset to be serum copper level and dysphagia diet administration duration, whereas multivariate analysis showed only serum copper level to be significant. Receiver operating characteristic analysis showed the serum copper level cut-off value to be 13 μg/dL with respect to development of anemia (sensitivity: 100%; specificity: 59%). In addition, oral copper supplementation for two months improved anemia in all 15 cases who were followed up. Conclusions: Patients receiving dysphagia diet are at risk of developing copper deficiency anemia. Copper supplementation is recommended for all older patients being prescribed this type of diet, and special attention is required in this respect.


Keywords:

Copper-Deficiency Anemia; Trace Element Deficiency; Dysphagia Diet; Dietary Supplement


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