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[Vitamin B12 deficiency in geriatrics].
Praxis (Bern 1994). 1999 Nov 04; 88(45):1867-75.P

Abstract

Cobalamin deficiency increases with advancing age. The cut-off point of serum concentration should be raised, because many elderly people with "normal" serum vitamin B12 concentrations are metabolically deficient in cobalamin. The measurement of the metabolites homocysteine and/or methylmalonic acid is recommended. Cobalamin deficiency may result in a variety of atypical symptoms. Hematological changes typical of megaloblastic anemia are absent in a majority of patients with neuropsychiatric disorders. Generally underlying pernicious anemia is not the main cause of cobalamin deficiency in the elderly. Protein-bound cobalamin malabsorption due to atrophic gastritis with hypo- or achlorhydria is a common cause of cobalamin deficiency in elderly people. An important manifestation of cobalamin deficiency is cognitive impairment. Much controversy exists on the subject of the association of dementia of the Alzheimer type with cobalamin deficiency. In several studies dementia has been related to low serum cobalamin levels. Physicians should be liberal of cobalamin therapy. The window of opportunity for effective intervention may be as short as one year from the onset of medical symptoms. At last a compilation of recommendations is given.

Authors+Show Affiliations

Bopp-Kistler I
Klinik für Geriatrie und Rehabilitation, Stadtspital Waid, Zürich. irene.bopp@waid.stzh.ch
Rüegger-Frey B
No affiliation info available
Grob D
No affiliation info available
Six P
No affiliation info available

MeSH

AgedAged, 80 and overDiagnosis, DifferentialFemaleGeriatric AssessmentHumansMaleNutritional RequirementsVitamin B 12Vitamin B 12 Deficiency

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

10589285

Citation

Bopp-Kistler, I, et al. "[Vitamin B12 Deficiency in Geriatrics]." Praxis, vol. 88, no. 45, 1999, pp. 1867-75.
Bopp-Kistler I, Rüegger-Frey B, Grob D, et al. [Vitamin B12 deficiency in geriatrics]. Praxis (Bern 1994). 1999;88(45):1867-75.
Bopp-Kistler, I., Rüegger-Frey, B., Grob, D., & Six, P. (1999). [Vitamin B12 deficiency in geriatrics]. Praxis, 88(45), 1867-75.
Bopp-Kistler I, et al. [Vitamin B12 Deficiency in Geriatrics]. Praxis (Bern 1994). 1999 Nov 4;88(45):1867-75. PubMed PMID: 10589285.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Vitamin B12 deficiency in geriatrics]. AU - Bopp-Kistler,I, AU - Rüegger-Frey,B, AU - Grob,D, AU - Six,P, PY - 1999/12/10/pubmed PY - 1999/12/10/medline PY - 1999/12/10/entrez SP - 1867 EP - 75 JF - Praxis JO - Praxis (Bern 1994) VL - 88 IS - 45 N2 - Cobalamin deficiency increases with advancing age. The cut-off point of serum concentration should be raised, because many elderly people with "normal" serum vitamin B12 concentrations are metabolically deficient in cobalamin. The measurement of the metabolites homocysteine and/or methylmalonic acid is recommended. Cobalamin deficiency may result in a variety of atypical symptoms. Hematological changes typical of megaloblastic anemia are absent in a majority of patients with neuropsychiatric disorders. Generally underlying pernicious anemia is not the main cause of cobalamin deficiency in the elderly. Protein-bound cobalamin malabsorption due to atrophic gastritis with hypo- or achlorhydria is a common cause of cobalamin deficiency in elderly people. An important manifestation of cobalamin deficiency is cognitive impairment. Much controversy exists on the subject of the association of dementia of the Alzheimer type with cobalamin deficiency. In several studies dementia has been related to low serum cobalamin levels. Physicians should be liberal of cobalamin therapy. The window of opportunity for effective intervention may be as short as one year from the onset of medical symptoms. At last a compilation of recommendations is given. SN - 1661-8157 UR - https://www.unboundmedicine.com/medline/citation/10589285/[Vitamin_B12_deficiency_in_geriatrics]_ DB - PRIME DP - Unbound Medicine ER -