Vitamin B12 deficiency common in older people

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MOLNLYCKE, SWEDEN. Swedish researchers have discovered that many older people are deficient in vitamin B12. Their study involved 368 men and women aged 75 years or older. Analysis of blood serum showed that 11 per cent of the participants were deficient in cobalamin (vitamin B12). The researchers point out that a vitamin B12 deficiency has been linked to neuropsychiatric disorders such as memory loss and dementia. The researchers discovered several cases of gastritis (inflammation of the lining of the stomach) and two cases of celiac disease among patients with low serum values of cobalamin. They conclude that routine screening for a vitamin B12 deficiency is justified in the case of older people.

In a separate letter to the Journal of the American Geriatrics Society doctors from the Union Memorial Hospital in Baltimore report on a case of vitamin B12 deficiency. The patient, an 85-year-old man, had developed progressive memory loss and lethargy over a two-year period. Although his serum level of vitamin B12 was within the currently accepted range, the doctors decided to proceed with vitamin B12 therapy. The patient received an intramuscular injection of 1000 micrograms of vitamin B12 for three consecutive days, then 1000 micrograms weekly for a month, and then one injection every month. By the fifth injection his mental status had vastly improved and his lethargy had completely vanished. The doctors conclude that the levels of serum vitamin B12 concentrations currently considered normal in the United States may be too low and should be reassessed. The lower limit of 200 pg/mL is based on the level that causes abnormalities in the blood (pernicious anaemia). In contrast the lower limit in Japan and some European countries is 500-550 pg/mL and is based on the level that causes mental manifestations such as dementia and memory loss. The doctors suggest that a trial of vitamin B12 therapy is warranted in patients with borderline cobalamin serum levels as it is effective and inexpensive.

Eggersten, Robert, et al. Prevalence and diagnosis of cobalamin deficiency in older people. Journal of the American Geriatrics Society, Vol. 44, No. 10, October 1996, pp. 1273-74
Goodman, Mark, et al. Are U.S. lower normal B12 limits too low? Journal of the American Geriatrics Society, Vol. 44, No. 10, October 1996, pp. 1274-75