Table 1.
Geriatric Laboratory Values and Interpretations of Hematology
Normal
Adult Value
Male (M)
Female (F)
Geriatric
Value
Hemoglobin
M 13.0 gm/dl
F 12.0 gm/dl
M 11.5 gm/dl
F 11.0 gm/dl
[down arrow]: Anemias,
cirrhosis of liver,
leukemias, Hodgkin's
disease, cancer (intestine,
rectum, liver, or bone),
kidney disease
[up arrow]: Dehydration,
COPD, CHF, polycythemia
Hematocrit
M 40%-54%
F 36%-46%
M 30%-45%
F 36%-65%
[down arrow]: Anemias,
leukemia, Hodgkin's
disease, multiple myeloma,
cirrhosis of liver, protein
malnutrition, peptic ulcer,
chronic renal failure,
rheumatoid arthritis
[up arrow]: Dehydration,
severe diarrhea,
polycythemia vera, diabetic
acidosis, emphysema,
transient cerebral ischemia
White Blood
Cells
4,500-10,000
[micro]l/
[mm.sup.3]
3,000-9,000
[micro]l/
[mm.sup.3]
[down arrow]: Hemotopoietic
diseases, viral infections,
alcoholism, systemic lupus
erythematous (SLE),
rheumatoid arthritis
[up arrow]: Acute
infection, tissue necrosis,
leukemias, hemolytic
anemia, parasitic diseases,
stress
Platelets
150,000400,000
[micro]l
Minimal
change
[down arrow]: Idiopathic
thrombocytopenia purpura,
multiple myeloma, cancer,
leukemias, anemias, liver
disease, SLE, kidney
disease
[up arrow]: Polycythemia,
trauma, post-splenectomy,
metastatic carcinoma,
pulmonary embolism,
tuberculosis
Test
Implications
Source: Brigden & Heathcote, 2000
Table 2.
Geriatric Laboratory Values and Interpretations of Erythrocyte
Sedimentation Rate, Iron Metabolism, and Vitamin [B.sub.12]
Normal
Adult Value
Male (M)
Female (F)
Geriatric
Value
Erythrocyte
Sedimentation
Rate (ESR)
M 0-15 mm/hr
F 0-20 mm/hr
M 0-40 mm/hr
F 0-45 mm/hr
[down arrow]:
Polycythemia, CHF,
degenerative arthritis,
angina pectoris
[up arrow]: Rheumatoid
arthritis, rheumatic
fever, acute MI, cancer
(stomach, colon, breast,
liver, kidney), Hodgkin's
disease, multiple
myeloma, bacterial
endocarditis, gout,
hepatitis, cirrhosis of
liver,
glomerulonephritis, SLE,
theophylline use.
Serum Iron
50-150
[micro]g/dl
60-80
[micro]g/dl
[down arrow]: Iron
deficiency anemia, cancer
(stomach, intestine,
rectum, breast), bleeding
peptic ulcers, protein
malnutrition
[up arrow]: Hemolytic,
pernicious, and folic
acid anemias; liver
damage; lead toxicity
Ferritin
M 15-445
ng/ml
F 10-235
ng/ml
10-310 ng/dl
[down arrow]: Iron
deficiency, inflammatory
bowel disease, gastric
surgery
[up arrow]: Metastatic
carcinoma, leukemias,
lymphomas, hepatic
diseases, anemias, acute
and chronic infection,
inflammation, tissue
damage
Vitamin
[B.sub.12]
200-900
pg/ml
150 pg/ml
[down arrow]: Pernicious
anemia, malabsorption
syndrome, liver disease,
hypothyroidism
[up arrow]: Acute
hepatitis
Test
Implications
Source: Brigden, 1999; Brigden & Heathcote, 2000; Kee, 2000; Tripp,
2000
Table 3.
Geriatric Laboratory Values and Interpretations of Serum Proteins
Test
Normal
Adult Value
Geriatric
Value
Total Protein
6.0-8.0 g/dl
5.6-7.6 g/dl
[down arrow]: Prolonged
malnutrition,
low-protein diet, cancer
(GI tract), severe liver
disease, chronic renal
failure
[up arrow]: Dehydration,
vomiting, multiple
myeloma
Albumin
3.0-5.0 g/dl
52- 8% of
total protein
Slight
decrease
[down arrow]: Severe
malnutrition, liver
failure, renal
disorders, prolonged
immobilization
[up arrow]: Dehydration,
severe vomiting,
diarrhea
Implications
Source: Beers & Berkow, 2000; Kee, 2002
Table 4.
Geriatric Laboratory Values and Interpretations of Selected Renal
Function Tests
Test
Normal
Adult Value
Geriatric
Value
BUN
5-25 mg/dl
8-28 mg/dl
or slightly
higher
[down arrow]: Liver
damage, low protein diet,
overhydration,
malnutrition
[up arrow]: Dehydration,
high protein diet, GI
bleeding, pre-renal
failure
Creatinine
0.5-1.5 mg/dl
0.6-1.2 mg/dl
[down arrow]: None for
older adult
[up arrow]: Renal failure,
shock, leukemia, SLE,
acute MI, CHF, diabetic
neuropathy
Creatinine
Clearance
85-135 ml/min
Formula
[down arrow]:
Mild-to-severe renal
impairment,
hyperthyroidism,
amyotrophic lateral
sclerosis, thiazide use
[up arrow]:
Implications
Hypothyroidism,
renal-vascular
hypertension
Source: Brigden & Heathcote, 2000; Engelberg et al., 2000;
Kennedy-Malone et al., 2004.
Table 5.
Estimating Creatinine Clearance Values for Men
Creatinine clearance =
(140 - age in years) x (body weight in kilograms)/
(72 x serum creatinine in mg/dl)
Table 6.
Geriatric Laboratory Values and Interpretations of Hepatic Enzymes
Normal
Adult Value
Male (M)
Female (F)
Geriatric
Value
Serum Alanine
Aminotransferase
(ALT, SGPT)
10-35 U/I
17-30 U/I
[down arrow]: Exercise,
salicylates
[up arrow]: Viral
hepatitis, liver
necrosis, CHF, acute
alcohol intoxication
Serum Aspartate
Aminotransferase
(AST, SGOT)
8-38 U/I
18-30 U/I
[down arrow]: Diabetic
ketoacidosis
[up arrow]: Acute MI,
hepatitis, liver
necrosis, musculoskeletal
disease and trauma,
pancreatitis, cancer
(liver), angina pectoris,
muscle trauma related to
IM injections
Alkaline
Phosphatase
20-130 U/I
30-140 U/I
[down arrow]:
Hypothyroidism,
malnutrition, pernicious
anemia
[up arrow]: Cancer
(liver, bone), hepatitis,
leukemia, healing
fractures, multiple
myeloma, rheumatoid
arthritis, ulcerative
disease
Gamma-GlutaMyltransferase
(GGT)
M 4-23 IU/I
F 3-12 IU/I
9-55 U/I
[down arrow]: None
[up arrow]: Cirrhosis of
liver, necrosis of liver,
alcoholism, hepatitis,
cancer (liver, pancreas,
Test
Implications
prostate, breast, kidney,
liver, lung), diabetes
mellitus, acute MI, CHF,
pancreatitis,
cholecystitis, nephritic
syndrome
Source: Brigden & Heathcote, 2000; Kee, 2002
Table 7.
Geriatric Laboratory Values and Interpretations of Blood Lipids
Test
Normal
Adult Value
Male (M)
Female (F)
Cholesterol
<200 mg/dl
M may
by 30
F may
by 55
High-Density
Lipoproteins
(HDL)
M >45 mg/dl
F >55 mg/dl
M increases
30% between
ages 30 and
F decreases
30% between
ages 30 and
Triglycerides
M 40-160
mg/dl
F 35-135
mg/dl
Geriatric
Value
Implications
increase
mg/dl
increase
mg/dl
by
80
by
80
M increases by
30%
F increases by
50%
[down arrow]:
Hyperthyroidism,
starvation,
malnutrition, anemia
[up arrow]: Acute MI,
atherosclerosis,
uncontrolled diabetes
mellitus,
hypothyroidism, biliary
obstruction, cirrhosis
[down arrow]: Chronic
obstructive lung disease
[up arrow]: Acute MI,
hypothyroidism, diabetes
mellitus, multiple
myeloma, high-fat diet
[down arrow]:
Hyperthyroidism,
hyperparathyroidism,
protein malnutrition,
exercise
[up arrow]: Acute MI,
hypertension,
hypothyroidism,
nephritic syndrome,
alcoholic cirrhosis,
pancreatitis,
high-carbohydrate diet
Source: Brigden & Heathcote, 2000; Kee, 2002
Table 8.
Geriatric Laboratory Values and Interpretations of Glucose, Selected
Electrolytes
Test
Normal
Adult Value
Geriatric
Value
Implications
Serum Glucose
70-110 mg/dl
70-120
mg/dl
[down arrow]: Hypoglycemia,
cancer (stomach, liver),
malnutrition, alcoholism,
cirrhosis of liver
[up arrow]: Diabetes
mellitus, adrenal gland
hyperfunction, acute MI,
stress, crushing injury,
renal failure, cancer
(pancreas), CHF
Calcium
4.5-5.5 mEq/I
No change
[down arrow]: Diarrhea,
lack of calcium intake,
chronic renal failure,
alcoholism, pancreatitis
[up arrow]:
Hyperparathyroidism,
malignant neoplasms (bone,
lung, breast, bladder,
kidney), malignant myeloma,
prolonged immobilization,
multiple fractures, renal
calculi
Potassium
3.5-5.3 mEq/I
Slight
increase
[down arrow]: Vomiting,
diarrhea, dehydration,
malnutrition, starvation,
stress, diabetic acidosis
[up arrow]: Acute renal
failure, acidosis
(metabolic or lactic),
crushing injury, Addison's
disease
Source: Kee, 2002; Kennedy-Malone et al., 2004; Martin et al., 1997;
Tripp, 2000
Table 9.
Geriatric Laboratory Values and Interpretations of Selected Blood Gases
Test
Normal
Adult Value
Geriatric
Value
Pa[O.sub.2]
75-100 mmHg
100.1-(0.325
x age)
[down arrow]: Emphysema,
pneumonia, pulmonary edema
[up arrow]:
Hyperventilation
Pa[Co.sub.2]
35-45 mmHg
2% per decade
[down arrow]:
Hyperventilation
[up arrow]: COPD
Implications
Source: Brigden & Heathcote, 2000; Kee, 2002; Martin et al., 1997
Table 10.
Geriatric Laboratory Values and Interpretations of Thyroxine,
Triiodothyronine, Prostate-Specific Antigen
Test
Normal
Adult Value
Male (M)
Female (F)
Geriatric
Value
Thyroxine
([T.sub.4])
4.5-11.5
[micro]g/dl
3.3-8.6
[micro]g/dl
[down arrow]:
Hypothyroidism, protein
malnutrition,
corticosteroids
[up arrow]:
Hyperthyroidism, viral
hepatitis, thyroiditis,
myasthenia gravis
ThyroidStimulating
Hormone TSH)
0.5-5.0
[micro]IU/ml
Slight
increase
[down arrow]: Excessive
thyroid hormone
replacement, Graves'
disease, primary
hyperthyroidism
[up arrow]: Primary
hypothyroidism, thyroid
hormone resistance
ProstateSpecific
Antigen (PSA)
PSA 1.45
ng/ml
Ages 50-59:
0.0-2.45 ng/ml
Ages 60-69:
0.0-5.0 ng/ml
Ages 70-79:
0.0-6.3 ng/ml
Post-radical
prostatectomy
0.0-0.3ng/ml
[up arrow]: Prostate
cancer, benign
prostatic hyperplasia
Implications
Source: Beers & Berkow, 2000; Daniels, 2002; Kee, 2002