Thiamine deficiency in hospitalized elderly patients

Area of Science:

• Geriatric Medicine
• Nutritional Science
• Clinical Biochemistry

Background:

• Thiamine deficiency is often underdiagnosed due to uncommon classical presentations.
• Anecdotal evidence suggests a link between thiamine deficiency and delirium, heart failure, and neuropathy in the elderly.
• Limited systematic research exists on thiamine status in elderly hospital patients.

Purpose of the Study:

• To investigate the prevalence of thiamine deficiency in elderly patients admitted to an acute geriatric unit.
• To explore the association between thiamine deficiency and the occurrence of delirium in this patient group.

Main Methods:

• Assessed thiamine levels using thiamine pyrophosphate effect (TPPE) in 36 non-demented, community-dwelling elderly patients.
• Compared thiamine status with the incidence of delirium and peripheral neuropathy (absent ankle jerks).
• Analyzed anthropometric indices and other nutrient deficiencies.

Main Results:

• Marginal thiamine deficiency (TPPE 15-24%) was found in 31% of patients; definite deficiency (TPPE > 25%) in 17%.
• Thiamine-deficient patients had a significantly higher incidence of delirium (76%) compared to those with normal status (32%).
• Absent ankle jerks were more prevalent in thiamine-deficient patients (41% vs 10%).

Conclusions:

• Thiamine deficiency is prevalent in elderly patients admitted to acute geriatric care.
• Thiamine deficiency may be an underrecognized contributor to delirium in elderly patients.
• Screening for thiamine deficiency in elderly patients may be warranted.