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Prevalence of vitamin B12 deficiency among geriatric outpatients.
J Fam Pract. 1992 Nov; 35(5):524-8.JF

Abstract

BACKGROUND

Healthy people can have low levels of cobalamin (vitamin B12) without symptoms or signs of cobalamin deficiency. Early detection of deficiency is imperative for treatment to be effective. Development of radioimmunoassay tests has greatly improved accurate determination of cobalamin (Cbl) levels. Nevertheless, results of studies of Cbl deficiency vary widely because of the variety of populations studied.

METHODS

In a prospective study, we tested 100 consecutive, unselected geriatric outpatients in a primary care setting to determine the prevalence of cobalamin deficiency. All patients, 65 years of age or older, who visited the office of one of the authors during a period of 11 consecutive working days, had their serum Cbl level checked. If the level was 299 pg/mL or lower, serum intrinsic factor and parietal cell antibodies, serum gastrin, part 1 Schilling test, serum methylmalonic acid, and total homocysteine were done, when possible, for the diagnosis of type A gastritis and intracellular Cbl deficiency.

RESULTS

Sixteen percent of geriatric outpatients had serum Cbl levels of 200 pg/mL or below, and 21% had levels between 201 and 299 pg/mL. Among the 16 patients with levels < or = 200 pg/mL, 2 patients had macrocytic anemia, 3 patients had peripheral neuropathy, and 8 patients had type A gastritis. Among the 21 patients with levels of 201 to 299 pg/mL, 2 patients had peripheral neuropathy, 9 patients had type A gastritis, and none of the patients had macrocytic anemia. Among the patients whose methylmalonic acid and total homocysteine levels were determined, the results were high in 80% of those with Cbl levels < or = 200 pg/mL and in 33% of those with levels from 201 to 299 pg/mL.

CONCLUSIONS

The prevalence of Cbl deficiency in geriatric outpatients was found to be higher than in any recent report. The lower limit of the normal range for Cbl level should be increased to 300 pg/mL.

Authors+Show Affiliations

Department of Family Practice, New York Medical College, Kingston 12401.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1331288

Citation

Yao, Y, et al. "Prevalence of Vitamin B12 Deficiency Among Geriatric Outpatients." The Journal of Family Practice, vol. 35, no. 5, 1992, pp. 524-8.
Yao Y, Yao SL, Yao SS, et al. Prevalence of vitamin B12 deficiency among geriatric outpatients. J Fam Pract. 1992;35(5):524-8.
Yao, Y., Yao, S. L., Yao, S. S., Yao, G., & Lou, W. (1992). Prevalence of vitamin B12 deficiency among geriatric outpatients. The Journal of Family Practice, 35(5), 524-8.
Yao Y, et al. Prevalence of Vitamin B12 Deficiency Among Geriatric Outpatients. J Fam Pract. 1992;35(5):524-8. PubMed PMID: 1331288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of vitamin B12 deficiency among geriatric outpatients. AU - Yao,Y, AU - Yao,S L, AU - Yao,S S, AU - Yao,G, AU - Lou,W, PY - 1992/11/1/pubmed PY - 1992/11/1/medline PY - 1992/11/1/entrez SP - 524 EP - 8 JF - The Journal of family practice JO - J Fam Pract VL - 35 IS - 5 N2 - BACKGROUND: Healthy people can have low levels of cobalamin (vitamin B12) without symptoms or signs of cobalamin deficiency. Early detection of deficiency is imperative for treatment to be effective. Development of radioimmunoassay tests has greatly improved accurate determination of cobalamin (Cbl) levels. Nevertheless, results of studies of Cbl deficiency vary widely because of the variety of populations studied. METHODS: In a prospective study, we tested 100 consecutive, unselected geriatric outpatients in a primary care setting to determine the prevalence of cobalamin deficiency. All patients, 65 years of age or older, who visited the office of one of the authors during a period of 11 consecutive working days, had their serum Cbl level checked. If the level was 299 pg/mL or lower, serum intrinsic factor and parietal cell antibodies, serum gastrin, part 1 Schilling test, serum methylmalonic acid, and total homocysteine were done, when possible, for the diagnosis of type A gastritis and intracellular Cbl deficiency. RESULTS: Sixteen percent of geriatric outpatients had serum Cbl levels of 200 pg/mL or below, and 21% had levels between 201 and 299 pg/mL. Among the 16 patients with levels < or = 200 pg/mL, 2 patients had macrocytic anemia, 3 patients had peripheral neuropathy, and 8 patients had type A gastritis. Among the 21 patients with levels of 201 to 299 pg/mL, 2 patients had peripheral neuropathy, 9 patients had type A gastritis, and none of the patients had macrocytic anemia. Among the patients whose methylmalonic acid and total homocysteine levels were determined, the results were high in 80% of those with Cbl levels < or = 200 pg/mL and in 33% of those with levels from 201 to 299 pg/mL. CONCLUSIONS: The prevalence of Cbl deficiency in geriatric outpatients was found to be higher than in any recent report. The lower limit of the normal range for Cbl level should be increased to 300 pg/mL. SN - 0094-3509 UR - https://www.unboundmedicine.com/medline/citation/1331288/Prevalence_of_vitamin_B12_deficiency_among_geriatric_outpatients_ DB - PRIME DP - Unbound Medicine ER -