Laboratory Values for Older Adults TEST NAN "ADULT NORMALS OLDER ADULT NORMALS ‘SGMFICANCE OF DEVIATIONS Hematalogy Red bloodoets ——M4.7-6.1millorvurit_ Unchanged with aging Low: homonthage, anemia, chron ss, (BOS) F42-5.4miloriunit Iuney csease, pernicious aneia igh: high alts, polycythemia, etyraton Heragitin M1418 git Values may be sihty Low: anemia, cancer, nuttional deficiency, Fietegde decreased wdney csease | High: polyothomia, har falure (HP), chronic ‘obstructive puimonary cisease (COPD), high truce, denyeation Hematoert 1M 4096-5096 Values may be aghty Low: anemia, cirhass, Remormane, FS7% 7% decreased mahutrton, houmatod artis High: poyoytiomia, severe dehydration, sever dares, COPD White blood cals §,000-10,000/mm? Unchanged with aging Low: drug towcty, infections, atoimmane (ECs) ota disease, dota dotcioncy High: nection, trauma, sess, intarmation Neutrophils ‘55-70% Unchanged with aging Low detary deficiency, overwhelming bacteria ‘ection, va infecons, drug therapy High: physical and emotional stress, trauma, ‘flammatory disorders Ecsinaphis 19%-4% Unchanged with aging Lave increased acrenosterid production igh: parasite nfecions, alec reactions, ‘sutormune disorders Boeophis O5K1% Unchanged with aging Lowe aout alge reactors, stress reactions igh: myeloprotferative disease Monocytes 28% Unchanged wih aging Low: crug therepy (predposton) igh: chranc inlamratory asorders, Tubercioss, chronic ulcerative cots Lymphocytes 20-40% Unchanged with aging Low leukemia, sepsis, systemic pus ‘eyhematosus, chemotherany, radiation High: chronic bactral infection, val infections, ‘action, infactous hepatitis Foto ac 5-28 ngimL Unchanged with aging Lae malnutrition, foe acid anemia, hemo ‘anemia, alcohol use disorder, ver csease, chronic keney sease High: pemicious aneria Vitamin B,. 460-860 pgimL___Unchanged with aging Tolalion binding 260-480 mop/cL Unchanged with aging Low: typoproteineia, cross, hemolyic capacity MBC) capacty (IBC) anemia, pernicous anomia High: pooh, ro-defclency anemia ron Fa 1M 80-180 meg/al Unchanged with aging Low: neufient tary ron, chronic blood F 60-160 mogdh. Joss, inadequate aberption oron High: hemecrremocytoss, hamolic anemia, hopatits, kon possoning ContesTEST NAME "ADULT NORMALS OLDER ADULT NORMALS. ‘SIGNIFICANCE OF DEVIATIONS. Ure acie M4.0-85 mg/dL Valuos may be slightly Low: lead poisoning F2.7-7.3 mg/dL inoreased High: gout, increased ingestion of purines, chronic kidney disease, hypothyrodiem Prothrombin time 110-1256 Unchanged with aging High: liver disease, vitamin K deficiency, rn) ‘wertarin ingestion, bile duct obstruction, salcyate intoxication Partial PTT: 60-708 Unchanged with aging Low: early stages of disseminated intravascular thromboplastin PTT: 30-408 Coagulation, metastatic cancer time PTD) High: coagulation factor deficiency, cirhosis, Paria! ‘vitamin K deficiency, heparin administration ‘thromboplastin time—activated (aT) Patelets 1150,000-400,000/ Unchanged with aging Low: hemohage, thrombocytopenia, systemic mm lupus erythematosus, pemicious anemia, Cchomotherapy, infecton High: makanancy, polyoythemia, choumatoid arthits, ron-defciency anomia Blood Chemistry Sodium 195-147 mEq. Unchanged with aging Low: decreased intake, diarrhea, vorting, diuretic administration, chronic kidney disease, HF, peripheral edema, ascites High: increased intake, Cushing syndrome, ‘extensive thermal burns Potassium 86-62 mEq Unchanged with aging Low: deficient intake, burns, diuretics, Cushing syndrome, insuln administration, ascites High: excessive ditary intake, kidney falur, infection, acidosis, dehyctration Chloride (95-106 mEqiL Unchanged with aging Low: overhydration, HF, voriting, chronic gastric suction, chronic respratory acidosis, hypokalemia, aurete therapy High: denydration, Cushing eynarome, kidney dysfunction, metabolic acidosis, yperventiation Calcium 9.0-10.5mg/oL_ Tends to decrease Low: Kidney falure, vtamin D deficiency, ‘osteomalacia, malabsorption High: Paget disease of the bone, protonged: immoblzation, lymphoma. Phosphate 3.0-4.5 mai. Values may be slighty ower Low: inadequate dietary ingestion, chronic ‘antacid ingestion, typercalcemia, alcohol use disorder, osteomalacia, malnutrition High: kidney failure, increased dietary intake, hypocalcemia, iver disease Magnesium 18-241 meg Decreases 15% between third Low: malnutition, malabsorption, alcohol ‘and eighth decade use disorder, disease in the ranal tubules, ypoparathyroicism High: chronic kidney disease, ingestion of ‘magnesium-containing antacids or sats, hypothyroidism Glucose, fasting for 74-108 mg/L. ‘Age 60-00 years: Low: hypothyroidism, Iver cssoase, insulin fasting bloed sugar 82-115 mg/dl. ‘overdose, starvation Fes) (Over age 90 years: High: diabetes melitus, acute stress response, 75-121 mala uretic therapy, conicosteroidtherany Glucose, Less than 140 mg/aL_ Less than 160 mg/dL 2 hours Low: hypothyroidism, insuln overdose, postprandial 2hoursafiermeal after meal ‘malabsorption High: diabetes metus, malwutrtion, Cushing syndrome, chronic kidney disease, ciuratic, ‘therapy, corticosteroid therapyTEST NAME "ADULTNORMALS OLDER ADULT NORMALS ‘SIGNIFICANCE OF DEVIATIONS “Amylase 60-120 Somogyi Values may be sightty High: acute pancreatitis, perforated bowel, vunits/aL, increased acute cholacystts, diabetic ketoacidosis ‘Glycosylated 4.0% 6.9% Unchanged with aging Low: hemolytic anemia, chronic kidney disease hemoglobin High: newly diagnosed diabetes, poory controled (Hob A.) diabetes, nondiabetic ypergyoemia Total protein 6489/6 Unchanged with aging Lowe ver cisease, mainutrtion, ascttes High: hernoconcentration Albumin 35-5091 ‘Values may be slighty Low: malnutrition, kver disease, overnydration decreesed High: dehydration Blood urea nitrogen 10-20 mg/d. ‘Values may be slightly Low: ner faire, overhycration, mainutrtion (Buy) increased High: hypovolomia, deiycation, alimentary tube feeding, kidney dsease Creatinine M:0.6-1.2 mg/dl Decrease in muscle mass Love: dobiltation, decreased muscle mass F:0.5-1.0 mg/dL. may ceuse decreased ‘High: reduced renel blood flow. diabetic values ‘neuropathy, urinary tract obstruction Creatinine clearance M 107-199 mL/min Values decrease 6.5 mLimin/ Love: impaired kidney function, HF, cithosis F'87-107 mL/min dacade of fe because of High: high cardiac output syndromes decline in GFR Cholesterol fota) ——< 200 mara Increases until about middle Low: malabsorption, malnutrition, cholesterol ‘age but decreases lowering medication, pernicious aneria, iver thereafter (or can increase disease, hyperthyroidism abruptly in women) High: hypercholesteremia, hypertipidemia, hhypothyroicism, uncontrolled dabetes, rmelltus, hypertension, stress High-density M5 48 mg/dL Unchanged with aging Low familial low HDL, Iver diseese, lipoprotein (HDL) F > 55 mg/dl. hypoprotainemia High: fara! HDL lipoproteinemia, excessive exercise Low-density < 180 mg/dl Increases with aging after Low hypolipoproteinemia lipoprotein (LDL) ‘menopause High: hypothyroidism, alcohol consumption, chronic liver disease, Cushing syndrome ‘Alkaline phosphetase 90-120 units. ‘Values may be slighty higher Low: hypothyroidism, malnutrtion, pericious ‘anemia High: cirrhosis, healing racture, Paget disease ‘Acid phosphatase 0.13-0.63 units. Unchanged with aging Low: thrombosis High: heparin aciministration, cinfosis, prostate cancer ‘Aspartate 0-86 units. ‘Values may be slighty higher Love acute kidney disease, dlabetic ‘aminotransferase ketoacidosis, chroric kidney dialysis @sp High: myopathy, hepatitis, ctthosis, multiple trauma, acute hemobtic anemia | Creatine kinase (CK) 20-200 units/L Unchanged with aging High: diseases or injury affecting heart muscle, skeletal muscle, and brain ‘Thyroid Testing Thyroxine (T,J—total M412meg/dl. —_—_‘Sightly decreased Low: hypothyroidism, malnuttion, kidney F512 megidL falure, cithosis High: hyparthyroésm, hepatitis Tiiodothyronine (T) Age 20-60 years: Values may be slighty Low: hypothyroicism, pituitary insufficiency, 70-208 ngidl ddocreased protoin mainuttion, kidnoy faire, iver Over age 50 years diseases, Cushing syndrome 40-180 ngid. High: hyperthyroidism, hepatitis, ‘Thyrod-stimutating hormone (TSH) 2-40 molW/mL. (varies by laboratory) Unchanged with aging hypoproteinemia Lows pituitary dysfunction, hyperthyroidism High: primary hypothyroicésmTEST NAME "ADUCT NORMALS OLDER ADULT NORMALS ‘SIGNIFICANCE OF DEVIATIONS Urine Chemistry Color Yelow; amber Unchanged with aging ‘Saw-colored urine indicates dition Appearance lear Unchanged with aging Cloudy urine may indicate presence of pus, casts, bood, and bacteria Specitc gravy 1.005-1.080 Values may be slightly Low: overhyaration, Kiney failure, curesis, decreased ypothorria High: denycration, water restriction, vomiting, danthea pH 46-80 Unchanged with aging ‘Acie urine: diarrhea, metaboic acidosis, diabetes melitus, respiratory acidosis, emphysema Alkaline urine: respiratory alkalosis, metabolic ‘akalosis, vomiting, gastric suctioning, [ diretic therapy, UTI | Protein 0-8 mg/mL. Unchanged with aging Positive: diabetes molitus, HF systemic lupus erythematosus, maignant hypertension Glucose Nogative Unchanged with aging Positive: diabetes molitus, Cushing syndrome, severe stress, infection, drug therapy Ketones Negative Unchenged with aging Positive: uncontoled diabetes mellitus, starvation, excessive aspirin Ingestion, high= protein det, dehycretion Blood Negative Unchanged with aging Positive: renal trauma, renal siones, cysts, prostatitis Leukocyte esterase Negative Unchenged with aging Positive: possible UT! Bacteria Negative May be seen in older adults Postive: UTI ‘without symotoms; evaluate for pyuria end symptoms Arterial Blood Gases pH 7.36-7.45 Unchanged with aging Lows respiratory or metabolic acidosis High: respiratory oF metabolic alkalosis Po, BO100mmHg Decreases 25% between 30 Low: cardiac or respiratory disease ‘and 80 years of age Peo, 35-45 mm Hg Unchenged with aging Low: respiratory alkalosis [ High: respiratory acidosis ©, saturation 96% 100% 95% Low: altered gas exchange HCO, 21-28 mEq/L Unchenged with aging Low: metabolic acidosis High: metabole acidosis HE, bear flue, OFF, homer ain at; UT, ny wane | ‘Adactod fom Pagara,K.D., Pagina, Pagaha,T.N, 2021. Mosy'sagnst and berate test rafroce (15h ed). Bt Lads, MO: Eo.