[Falling due to vitamin B12 deficiency]

Area of Science:

• Neurology
• Geriatrics
• Nutritional Science

Background:

• Vitamin B12 deficiency is a known cause of neurological issues, including ataxia, particularly in elderly populations.
• Falls are a significant health concern in older adults, often linked to gait disturbances.

Observation:

• An 86-year-old woman presented with progressive functional decline and significant gait problems, including ataxia and inability to stand unaided.
• Laboratory findings revealed macrocytic anemia, severe vitamin B12 deficiency, and autoantibodies against intrinsic factor and parietal cells.
• The patient reported a history of regular falls, consistent with her observed gait impairment.

Findings:

• The patient was diagnosed with ataxia and falls secondary to vitamin B12 deficiency.
• Vitamin B12 supplementation led to a notable improvement in the patient's gait and stability.
• This case highlights that ataxia from vitamin B12 deficiency can occur without accompanying anemia in 20-25% of cases.

Implications:

• Early diagnosis and treatment of vitamin B12 deficiency are crucial for preventing irreversible neurological damage and falls in the elderly.
• This case underscores the importance of considering nutritional deficiencies in the differential diagnosis of gait disorders in geriatric patients.
• Investigating vitamin B12 levels should be considered in elderly individuals presenting with unexplained ataxia and falls.