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Vitamin B-12 deficiency in the elderly: current dilemmas Stabler SP; Lindenbaum J; Allen RHAm J Clin Nutr 1997[Oct]; 66 (4): 741-9Vitamin B-12 deficiency is present in up to 15% of the elderly population as documented by elevated methylmalonic acid with or without elevated total homocysteine concentrations in combination with low or low-normal vitamin B-12 concentrations. Clinical signs and symptoms of vitamin B-12 deficiency are insensitive in elderly subjects and comorbidity in these subjects makes responses to therapy difficult to interpret. Many elderly subjects with hyperhomocysteinemia have undiagnosed vitamin B-12 deficiency with elevated serum methylmalonic acid concentrations. Therefore, such elderly subjects should not receive folic acid supplementation before their vitamin B-12 status is diagnosed. Oral vitamin B-12 supplementation may be effective in lowering serum methylmalonic acid values in the elderly. However, the dose of vitamin B-12 in most common multivitamin preparations is too low for this purpose. Research efforts should be directed toward determining practical methods for diagnosing and treating vitamin B-12 deficiency in the millions of elderly subjects with undiagnosed deficiency.|Acyl Coenzyme A/metabolism[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Female[MESH]|Homocysteine/*blood[MESH]|Humans[MESH]|Male[MESH]|Methionine/metabolism[MESH]|Methylmalonic Acid/*blood[MESH]|Middle Aged[MESH]|Vitamin B 12 Deficiency/*blood/drug therapy/metabolism[MESH]|Vitamin B 12/administration & dosage[MESH] |
