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Vitamin B12 and folate and the risk of anemia in old age: the Leiden 85-Plus Study.
Arch Intern Med. 2008 Nov 10; 168(20):2238-44.AI

Abstract

BACKGROUND

Screening for deficiencies in vitamin B(12) and folate is advocated to prevent anemia in very elderly individuals. However, the effects of vitamin B(12) and folate deficiency on the development of anemia in old age have not yet been established.

METHODS

The current study is embedded in the Leiden 85-Plus Study, a population-based prospective study of subjects aged 85 years. Levels of vitamin B(12), folate, and homocysteine were determined at baseline. Hemoglobin levels and mean corpuscular volume (MCV) were determined annually during 5 years of follow-up.

RESULTS

We analyzed data from 423 subjects who did not use any form of cyanocobalamin, hydroxocobalamin, or folic acid supplementation, neither at baseline nor during follow-up. Folate deficiency (<7 nmol/L; n = 34) and elevated homocysteine levels (>13.5 mumol/L; n = 194) were associated with anemia at baseline (adjusted odds ratio [OR], 2.44; 95% confidence interval [CI], 1.06-5.61; and adjusted OR, 1.82; 95% CI, 1.08-3.06, respectively), but vitamin B(12) deficiency (<150 pmol/L; n = 68) was not (adjusted OR, 1.51; 95% CI, 0.79-2.87). Furthermore, vitamin B(12) deficiency was not associated with the development of anemia during follow-up (adjusted HR, 0.92; 95% CI, 0.46-1.82) or with changes in MCV (adjusted linear mixed model; P = .77). Both folate deficiency and elevated homocysteine levels were associated with the development of anemia from age 85 years onward (adjusted HR, 3.33; 95% CI, 1.55-7.14; and adjusted HR, 1.70; 95% CI, 1.01-2.88, respectively), but not with an increase in MCV over time (P > .30).

CONCLUSION

In the general population of very elderly individuals, anemia in 85-year-old subjects is associated with folate deficiency and elevated homocysteine levels but not with vitamin B(12) deficiency.

Authors+Show Affiliations

Department of Public Health and Primary Care, Leiden University Medical Center, Post Zone V-0-P, PO Box 9600, 2300 RC Leiden, the Netherlands. w.p.j.den_elzen@lumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19001201

Citation

den Elzen, Wendy P J., et al. "Vitamin B12 and Folate and the Risk of Anemia in Old Age: the Leiden 85-Plus Study." Archives of Internal Medicine, vol. 168, no. 20, 2008, pp. 2238-44.
den Elzen WP, Westendorp RG, Frölich M, et al. Vitamin B12 and folate and the risk of anemia in old age: the Leiden 85-Plus Study. Arch Intern Med. 2008;168(20):2238-44.
den Elzen, W. P., Westendorp, R. G., Frölich, M., de Ruijter, W., Assendelft, W. J., & Gussekloo, J. (2008). Vitamin B12 and folate and the risk of anemia in old age: the Leiden 85-Plus Study. Archives of Internal Medicine, 168(20), 2238-44. https://doi.org/10.1001/archinte.168.20.2238
den Elzen WP, et al. Vitamin B12 and Folate and the Risk of Anemia in Old Age: the Leiden 85-Plus Study. Arch Intern Med. 2008 Nov 10;168(20):2238-44. PubMed PMID: 19001201.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin B12 and folate and the risk of anemia in old age: the Leiden 85-Plus Study. AU - den Elzen,Wendy P J, AU - Westendorp,Rudi G J, AU - Frölich,Marijke, AU - de Ruijter,Wouter, AU - Assendelft,Willem J J, AU - Gussekloo,Jacobijn, PY - 2008/11/13/pubmed PY - 2008/12/17/medline PY - 2008/11/13/entrez SP - 2238 EP - 44 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 168 IS - 20 N2 - BACKGROUND: Screening for deficiencies in vitamin B(12) and folate is advocated to prevent anemia in very elderly individuals. However, the effects of vitamin B(12) and folate deficiency on the development of anemia in old age have not yet been established. METHODS: The current study is embedded in the Leiden 85-Plus Study, a population-based prospective study of subjects aged 85 years. Levels of vitamin B(12), folate, and homocysteine were determined at baseline. Hemoglobin levels and mean corpuscular volume (MCV) were determined annually during 5 years of follow-up. RESULTS: We analyzed data from 423 subjects who did not use any form of cyanocobalamin, hydroxocobalamin, or folic acid supplementation, neither at baseline nor during follow-up. Folate deficiency (<7 nmol/L; n = 34) and elevated homocysteine levels (>13.5 mumol/L; n = 194) were associated with anemia at baseline (adjusted odds ratio [OR], 2.44; 95% confidence interval [CI], 1.06-5.61; and adjusted OR, 1.82; 95% CI, 1.08-3.06, respectively), but vitamin B(12) deficiency (<150 pmol/L; n = 68) was not (adjusted OR, 1.51; 95% CI, 0.79-2.87). Furthermore, vitamin B(12) deficiency was not associated with the development of anemia during follow-up (adjusted HR, 0.92; 95% CI, 0.46-1.82) or with changes in MCV (adjusted linear mixed model; P = .77). Both folate deficiency and elevated homocysteine levels were associated with the development of anemia from age 85 years onward (adjusted HR, 3.33; 95% CI, 1.55-7.14; and adjusted HR, 1.70; 95% CI, 1.01-2.88, respectively), but not with an increase in MCV over time (P > .30). CONCLUSION: In the general population of very elderly individuals, anemia in 85-year-old subjects is associated with folate deficiency and elevated homocysteine levels but not with vitamin B(12) deficiency. SN - 1538-3679 UR - https://www.unboundmedicine.com/medline/citation/19001201/Vitamin_B12_and_folate_and_the_risk_of_anemia_in_old_age:_the_Leiden_85_Plus_Study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.168.20.2238 DB - PRIME DP - Unbound Medicine ER -