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[Vitamin B12 deficiency in the elderly]
1Klinik für Allgemeine Innere Medizin und Altersmedizin, Alexianer Krefeld GmbH, Dießemer Bruch 81, 47805, Krefeld, Deutschland, andreas.leischker@alexianer.de.
Zeitschrift Fur Gerontologie Und Geriatrie
|January 15, 2015
Summary
Vitamin B12 deficiency is common in older adults, vegans, and those with dementia. Early diagnosis and treatment, especially with parenteral hydroxocobalamin for severe symptoms, are crucial for reversing most manifestations.
Area of Science:
- Biochemistry
- Geriatrics
- Nutrition
Context:
- Vitamin B12 deficiency prevalence increases with age.
- Dementia patients and their spouses are at higher risk.
- Vegans are susceptible due to dietary restrictions.
Purpose:
- To review the physiology and pathophysiology of vitamin B12 metabolism.
- To present a practical, health-economic algorithm for diagnosing vitamin B12 deficiency.
- To guide early identification and treatment of both typical and atypical presentations.
Summary:
- Vitamin B12 is found in animal products; deficiency can occur with age, dementia, or vegan diets.
- Most symptoms, excluding dementia-related ones, are reversible with timely and appropriate therapy.
- A diagnostic algorithm considering economic factors is provided for rational laboratory testing.
- Parenteral hydroxocobalamin is recommended for initial treatment of severe neurological symptoms.
Impact:
- Facilitates early detection and intervention for vitamin B12 deficiency.
- Highlights the importance of considering vitamin B12 status in at-risk populations.
- Provides a framework for cost-effective laboratory diagnosis.
- Emphasizes the reversibility of most deficiency symptoms with prompt treatment.
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