Cobalamin Deficiency in the Elderly

Mediterranean Journal of Hematology and Infectious Diseases
Giacomo MarchiDomenico Girelli

Abstract

Older people are at risk for cobalamin (vitamin B12) deficiency because of a number of common disorders (e.g., autoimmune gastritis) and drugs (e.g., antacids) that may alter its absorption and utilization. The prevalence of cobalamin deficiency increases with age, resulting, particularly elevated, in frail and institutionalized subjects. At variance with common sense, the diagnosis is far from simple. It requires a high degree of suspicion, due to heterogeneity and non-specificity of the signs and symptoms, ranging from macrocytosis (with or without anemia) to neuropsychiatric manifestations, that characterize several other aging-related disorders, like hematological malignancies, diabetes, hypothyroidism or vasculopathy. Furthermore, the detection of low levels of serum vitamin B12 appears poorly sensitive and specific. Other biomarkers, like serum homocysteine or methylmalonic acid, have improved the diagnostic possibilities but are expensive, not widely available, and may be influenced by some confounders (e.g., folate deficiency, or chronic renal failure). Early recognition and treatment are crucial since a proportion of patients develop severe complications, such as bone marrow failure and irreversible neurological impair...Continue Reading

Citations

Apr 10, 2021·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·O A ShavlovskayaYu D Yukhnovskaya
Aug 12, 2021·British Journal of Nursing : BJN·Mariusz Adam Tuz, Aby Mitchell

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