Vitamin B12 deficiency in the aged: a population-based study

Age and Ageing 2007 36(2):177-183.

Vitamin B12 deficiency in the aged: a population-based study

Saila Loikas1,2,, Pertti Koskinen1,2, Kerttu Irjala1,3, Minna
Löppönen4,5, Raimo Isoaho4,6, Sirkka-Liisa Kivelä4,7,8 and Tarja-
Terttu Pelliniemi1,2
1 Department of Clinical Chemistry, University of Turku, Turku,
Finland
2 TYKSLAB, Hospital District of Southwest Finland, Turku, Finland
3 Mehiläinen Oy, Turku, Finland
4 Institute of Clinical Medicine, Family Medicine, University of
Turku, Turku, Finland
5 Härkätie Health Centre, Lieto, Finland
6 Pori Health Centre, Pori, Finland
7 Unit of Family Medicine, Turku University Central Hospital, Turku,
Finland
8 Satakunta Central Hospital, Pori, Finland

Address correspondence to: S. Loikas. Fax: 358-2-2613920. Email:
sailalo@xxxxxx

Background: vitamin B12 deficiency is common in the aged, but it is
controversial whether only some risk groups should be investigated
instead of screening the entire aged population.

Objectives: to describe the prevalence of vitamin B12 deficiency in
the Finnish aged, and to find out if the subjects especially prone to
vitamin B12 deficiency could be identified by the risk factors or
clinical correlates.

Design: a cross-sectional, population-based study of 1048 aged
subjects (age 65-100 years) was carried out. Data on lifestyle factors
and clinical conditions were collected, physical examinations were
conducted and laboratory variables related to vitamin B12 were
measured.

Results: vitamin B12 deficiency had been previously diagnosed in 27
(2.6%) subjects, and a laboratory diagnosis (total vitamin B12 <150
pmol/l, or total vitamin B12 150-250 pmol/l and holotranscobalamin 37
pmol/l and homocysteine 15 µmol/l) was made for 97 (9.5%) subjects.
Low serum total vitamin B12 (<150 pmol/l) was observed in 6.1% and
borderline total vitamin B12 (150-250 pmol/l) in 32% of the subjects.
Male gender (OR 1.9, 95% CI 1.2-2.9), age 75 (OR 2.2, 95% CI 1.4-3.4)
and refraining from milk products (OR 2.3, 95% CI 1.2-4.4) increased
the probability for vitamin B12 deficiency. Anaemia (OR 1.3, 95% CI
0.7-2.3) or macrocytosis (OR 1.2, 95% CI 0.6-2.7) did not predict
vitamin B12 deficiency.

Conclusion: undiagnosed vitamin B12 deficiency is remarkably common in
the aged, but no specific risk group for screening can be identified.
Thus, biochemical screening of unselected aged population is
justified. General practitioners play a key role in diagnosing early
vitamin B12 deficiency.


Marilyn

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