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Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment.
Am J Med. 2005 Oct; 118(10):1154-9.AJ

Abstract

PURPOSE

Approximately 15% of people aged more than 60 years old have a cobalamin (vitamin B12) deficiency, mainly in relation with food-cobalamin malabsorption (FCM). To date, no study has documented this disorder in the elderly. There is also little information on clinical consequences.

SUBJECTS AND METHODS

We studied 92 elderly patients with well-established FCM who were extracted from an observational cohort study (1995-2004) of 172 consecutive elderly patients with documented cobalamin deficiency.

RESULTS

The median patient age was 76 +/- 8 years; 60 patients were women. The most common clinical manifestations were neurologic or psychologic: mild sensory polyneuropathy (44.6%), confusion or impaired mental functioning (22.8%), and physical asthenia (20.7%). Hematologic abnormalities were reported in at least one third of the patients: anemia (21%), leukopenia (10.9%), thrombopenia (8.7%), and pancytopenia (6.5%). All patients had low serum vitamin B12 levels (<200 pg/mL), with a mean value (+/- standard deviation) of 131 +/- 38 pg/mL and total serum homocysteine level of 22.1 +/- 9.3 micromol/L. The mean hemoglobin level was 10.9 +/- 2.5 g/dL and the mean erythrocyte cell volume 95.7 +/- 12.7 fL. Correction of the serum vitamin B12 levels and hematologic abnormalities was achieved equally well in patients treated with either intramuscular or oral crystalline cyanocobalamin.

CONCLUSIONS

This study suggests that in elderly patients, FCM may be associated with significant neurologic, psychologic, and hematologic abnormalities, which seem to respond equally well to either oral or parenteral vitamin B12 therapy.

Authors+Show Affiliations

Andrès E
Department of Internal Medicine, Diabetes and Metabolic Disorders, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. emmanuel.andres@chru-strasbourg.fr
Affenberger S
No affiliation info available
Vinzio S
No affiliation info available
Kurtz JE
No affiliation info available
Noel E
No affiliation info available
Kaltenbach G
No affiliation info available
Maloisel F
No affiliation info available
Schlienger JL
No affiliation info available
Blicklé JF
No affiliation info available

MeSH

AgedAged, 80 and overAstheniaCognition DisordersCohort StudiesConfusionEdemaErythrocyte IndicesFemaleFollow-Up StudiesGastritis, AtrophicHematologic DiseasesHemoglobinsHomocysteineHumansJaundiceMalabsorption SyndromesMaleParesthesiaPolyneuropathiesReflex, AbnormalRetrospective StudiesVitamin B 12Vitamin B 12 Deficiency

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16194648

Citation

Andrès, Emmanuel, et al. "Food-cobalamin Malabsorption in Elderly Patients: Clinical Manifestations and Treatment." The American Journal of Medicine, vol. 118, no. 10, 2005, pp. 1154-9.
Andrès E, Affenberger S, Vinzio S, et al. Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment. Am J Med. 2005;118(10):1154-9.
Andrès, E., Affenberger, S., Vinzio, S., Kurtz, J. E., Noel, E., Kaltenbach, G., Maloisel, F., Schlienger, J. L., & Blicklé, J. F. (2005). Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment. The American Journal of Medicine, 118(10), 1154-9.
Andrès E, et al. Food-cobalamin Malabsorption in Elderly Patients: Clinical Manifestations and Treatment. Am J Med. 2005;118(10):1154-9. PubMed PMID: 16194648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment. AU - Andrès,Emmanuel, AU - Affenberger,Stéphane, AU - Vinzio,Stéphane, AU - Kurtz,Jean-Emmanuel, AU - Noel,Esther, AU - Kaltenbach,Georges, AU - Maloisel,Frédéric, AU - Schlienger,Jean-Louis, AU - Blicklé,Jean-Frédéric, PY - 2004/10/24/received PY - 2005/02/02/accepted PY - 2005/10/1/pubmed PY - 2005/12/13/medline PY - 2005/10/1/entrez SP - 1154 EP - 9 JF - The American journal of medicine JO - Am J Med VL - 118 IS - 10 N2 - PURPOSE: Approximately 15% of people aged more than 60 years old have a cobalamin (vitamin B12) deficiency, mainly in relation with food-cobalamin malabsorption (FCM). To date, no study has documented this disorder in the elderly. There is also little information on clinical consequences. SUBJECTS AND METHODS: We studied 92 elderly patients with well-established FCM who were extracted from an observational cohort study (1995-2004) of 172 consecutive elderly patients with documented cobalamin deficiency. RESULTS: The median patient age was 76 +/- 8 years; 60 patients were women. The most common clinical manifestations were neurologic or psychologic: mild sensory polyneuropathy (44.6%), confusion or impaired mental functioning (22.8%), and physical asthenia (20.7%). Hematologic abnormalities were reported in at least one third of the patients: anemia (21%), leukopenia (10.9%), thrombopenia (8.7%), and pancytopenia (6.5%). All patients had low serum vitamin B12 levels (<200 pg/mL), with a mean value (+/- standard deviation) of 131 +/- 38 pg/mL and total serum homocysteine level of 22.1 +/- 9.3 micromol/L. The mean hemoglobin level was 10.9 +/- 2.5 g/dL and the mean erythrocyte cell volume 95.7 +/- 12.7 fL. Correction of the serum vitamin B12 levels and hematologic abnormalities was achieved equally well in patients treated with either intramuscular or oral crystalline cyanocobalamin. CONCLUSIONS: This study suggests that in elderly patients, FCM may be associated with significant neurologic, psychologic, and hematologic abnormalities, which seem to respond equally well to either oral or parenteral vitamin B12 therapy. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/16194648/Food_cobalamin_malabsorption_in_elderly_patients:_clinical_manifestations_and_treatment_ DB - PRIME DP - Unbound Medicine ER -