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Am J Clin Nutr. 1997 Oct;66(4):741-9.

Vitamin B-12 deficiency in the elderly: current dilemmas.

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1
Department of Medicine, University of Colorado Health Sciences Center, Denver 80220, USA. jonesjo@jove.UCHSC.edu

Abstract

Vitamin B-12 deficiency is present in up to 15% of the elderly population as documented by elevated methylmalonic acid with or without elevated total homocysteine concentrations in combination with low or low-normal vitamin B-12 concentrations. Clinical signs and symptoms of vitamin B-12 deficiency are insensitive in elderly subjects and comorbidity in these subjects makes responses to therapy difficult to interpret. Many elderly subjects with hyperhomocysteinemia have undiagnosed vitamin B-12 deficiency with elevated serum methylmalonic acid concentrations. Therefore, such elderly subjects should not receive folic acid supplementation before their vitamin B-12 status is diagnosed. Oral vitamin B-12 supplementation may be effective in lowering serum methylmalonic acid values in the elderly. However, the dose of vitamin B-12 in most common multivitamin preparations is too low for this purpose. Research efforts should be directed toward determining practical methods for diagnosing and treating vitamin B-12 deficiency in the millions of elderly subjects with undiagnosed deficiency.

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PMID:
9322547
[Indexed for MEDLINE]
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