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[Vitamin B12 (cobalamin)-deficiency in the elderly]
E Joosten1, W Pelemans, M Hiele
1Universitair Ziekenhuis St. Pieter, Leuven, Belgiäe.
Nederlands Tijdschrift Voor Geneeskunde
|March 31, 1990
Summary
Low vitamin B12 levels are present in 7.5% of elderly patients, with many showing normal red blood cell size. Further investigation is needed to confirm vitamin B12 deficiency in geriatric patients.
Area of Science:
- Geriatric Medicine
- Hematology
Context:
- Assessing the clinical significance of low serum vitamin B12 in elderly individuals admitted to a geriatric ward.
- Investigating the prevalence of vitamin B12 deficiency and its correlation with anemia and red blood cell indices in this population.
Purpose:
- To determine the relevance of low serum vitamin B12 concentrations in elderly patients.
- To evaluate the diagnostic utility of serum vitamin B12 levels in identifying deficiency in a geriatric setting.
Summary:
- Serum vitamin B12 levels were measured in 292 elderly patients; 7.5% had low levels. Anemia prevalence was 27%, with no significant difference in vitamin B12 levels between anemic and non-anemic groups.
- In a separate cohort of 178 anemic patients, 9.5% had vitamin B12 deficiency, often without typical indicators like low mean corpuscular volume (MCV) or hypersegmented neutrophils.
- Pernicious anemia was diagnosed in only one patient, highlighting the limitations of traditional indicators.
Impact:
- Serum vitamin B12 testing is crucial for detecting deficiency in the elderly.
- A low vitamin B12 level necessitates further diagnostic workup to confirm deficiency and determine its cause in geriatric patients.