A 75-year-old woman has increasing shortness of breath on exertion. Findings on physical examination are unremarkable. X-rays of the chest show no abnormalities of the heart or lungs. Pertinent laboratory findings include:Hematocrit: 28%Hemoglobin: 9 g/dLMean corpuscular volume: 70μm3Which of the following is the most likely basis for these findings?