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Masked vitamin B12 and folate deficiency in the elderly

Published online by Cambridge University Press:  24 July 2007

G. M. Craig
Affiliation:
Department of Geriatric Medicine, St Thomas's Hospital, London SE1 7EH
C. Elliot
Affiliation:
Department of Geriatric Medicine, St Thomas's Hospital, London SE1 7EH
K. R. Hughes
Affiliation:
Department of Geriatric Medicine, St Thomas's Hospital, London SE1 7EH
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Abstract

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1. A high incidence of vitamin B12 or folate deficiency, or both, may be found in the elderly, particularly those in hospital. This report concerns fifty cases detected in an inner-city-area geriatric unit during the course of routine clinical investigation. The majority had none of the classical haematological signs of vitamin B12 or folate deficiency, and all the patients reported had a mean corpuscular volume (MCV) of less than 100 fl.

2. There was a significant negative correlation between the MCV and the erythrocyte folate (P< 0.01), supporting earlier published work using a low serum folate as an index of folate deficiency.

3. There was no correlation between the MCV and the serum vitamin B12. Published work differs on this point.

4. Serum iron, total Fe-binding capacity and percentage Fe saturation results were available in forty patients in this series. There was a significant positive correlation between the serum Fe and the MCV (P<0.01) and 34% of patients had haematological evidence of Fe deficiency. In the majority, however, there was no evidence that associated Fe deficiency had masked the haematological signs of vitamin B12 or folate deficiency.

5. More attention should be paid to the problem of ‘masked’ vitamin B12 and folate deficiency in the elderly. There is a case for routine screening of the elderly for vitamin B12 and folate deficiency irrespective of the MCV.

Type
Papers of direct relevance to Clinical and Human Nutrition
Copyright
Copyright © The Nutrition Society 1985

References

Brynskow, J., Anderson, K., Gimsing, P. & Hippe, E. (1983). Lancet i, 11041105.CrossRefGoogle Scholar
Cole, M. G. & Prchal, J. F. (1984). Age and Ageing 13, 101105.Google Scholar
Cox, E. V., Meynell, M. J., Gaddie, R. & Cooke, W. T. (1959). Lancet ii, 9981001.CrossRefGoogle Scholar
Dawson, D. W., Sawers, A. H. & Sharma, R. K. (1984). British Medical Journal 288, 675678.CrossRefGoogle Scholar
Guthrie, D. L. & Priest, C. J. (1983). Medical and Laboratory Science 40, 95.Google Scholar
Hurdle, A. D. F. & Picton Williams, T. C. (1966). British Medical Journal ii, 202205.Google Scholar
Langdon, F.W. (1905). Journal of the American Medical Association 45, 16351638.CrossRefGoogle Scholar
Mollin, P. L., Anderson, B. B. & Burman, J. F. (1976). Clinics in Haematology 5, 524529.CrossRefGoogle Scholar
Munasinghe, D. R. & Pritchard, J. G. (1978). British Journal of Clinical Practice 32, 1618.Google Scholar
Pathy, M. S. & Newcombe, R. G. (1980). Gerontology 26, 3442.Google Scholar
Pederson, J., Lund, J., Ohlsen, A. S. & Kristenson, M. P. O. (1957). Lancet i, 448453.Google Scholar
Reynolds, E. H. (1976). Clinics in Haematology 5, 661696.Google Scholar
Roberts, P. D., St. John, D. J. B., Sinha, R., Stewart, J. S., Baird, I. M., Coghill, N. F. & Morgan, J. V. (1977). British Journal of Haematology 20, 165176.CrossRefGoogle Scholar
Sheridan, D. J., Temperley, I. J. & Gatenby, P. B. B. (1974). Journal of the Irish Colleges of Physicians and Surgeons 4, 3945.Google Scholar
Smith, A. D. M. (1960). British Medical Journal ii, 18401845.CrossRefGoogle Scholar
Sneath, P., Chanarin, I., Hodkinson, H. M., McPherson, C. K. & Reynolds, E. H. (1973). Age and Ageing 2, 177182.CrossRefGoogle Scholar
Strachan, R. W. & Henderson, J. G. (1965). Quarterly Journal of Medicine 34, 303317.Google Scholar
Technicon Instrument Co. Ltd (1976). Technicon Methodology Sheet SF4–0025 F14. Basingstoke: Technicon Instrument Co. Ltd.Google Scholar
Tisman, G. & Herbert, V. (1973). Blood 41, 465469.CrossRefGoogle Scholar