Related Experiment Videos
Cobalamin and folate deficiency in the elderly
1Department of Medicine, Queens University, Kingston, Ontario, Canada.
Bailliere'S Clinical Haematology
|September 1, 1995
Summary
Elderly individuals often have low folate and cobalamin levels, with biochemical signs of deficiency. While treatment corrects these, clinical benefits are minimal, though treating is still advised.
Area of Science:
- Gerontology
- Nutritional Biochemistry
- Hematology
Background:
- Elderly populations frequently exhibit low serum and erythrocyte folate, and serum cobalamin levels.
- Many with low vitamin levels present biochemical abnormalities indicative of true deficiency, such as elevated homocysteine and methylmalonic acid.
- While vitamin therapy corrects biochemical defects, significant clinical consequences are uncommon in the elderly.
Purpose of the Study:
- To investigate the clinical significance of low folate and cobalamin levels in the elderly.
- To evaluate the impact of vitamin replacement therapy on biochemical and clinical outcomes in older adults.
- To identify the primary causes of vitamin deficiency in this demographic.
Main Methods:
- Review of existing literature on vitamin B12 and folate status in elderly populations.
- Analysis of biochemical markers of deficiency and response to supplementation.
- Assessment of clinical outcomes, including hematological and neurological function, following vitamin therapy.
Main Results:
- Low folate and cobalamin levels are common in the elderly, often with biochemical evidence of deficiency.
- Vitamin therapy effectively reverses biochemical abnormalities but shows limited improvement in hemoglobin levels or overall neurological function.
- Megaloblastic anemia is rare, and pernicious anemia is an infrequent cause of low cobalamin levels in population studies.
Conclusions:
- Despite uncertain clinical benefits, treating elderly individuals with low cobalamin or folate is recommended.
- Crystalline vitamin B12 and folic acid are suitable for replacement therapy, excluding cases of pernicious anemia.
- Potential hazards like vascular damage from elevated homocysteine warrant consideration, with dietary insufficiency and malabsorption as likely causes.