Prevalence and predictors of subclinical micronutrient deficiency in German older adults: Results from the population-based KORA-Age study

Abstract

Subclinical micronutrient deficiency in older adults is associated with chronic age-related diseases and adverse functional outcomes. In Germany, the older population is at risk of insufficient micronutrient intake, but representative studies on micronutrient status in old and very old adults are scarce. This study's objectives were to estimate the prevalence of subclinical vitamin D, folate, vitamin B 12 and iron deficiencies among older adults, aged 65 to 93, from the KORA-Age study in Augsburg, Germany (n = 1079), and to examine associated predictors, using multiple logistic regression. Serum concentrations of 25-hydroxyvitamin D (25OHD), folate, vitamin B 12 , and iron were analyzed. The prevalence of subclinical vitamin D and vitamin B 12 deficiencies were high, with 52.0% and 27.3% of individuals having low 25OHD (<50 nmol/L) and low vitamin B 12 concentrations (<221 pmol/L), respectively. Furthermore, 11.0% had low iron (men <11.6 µmol/L, women <9.0 µmol/L) and 8.7% had low folate levels (<13.6 nmol/L). Common predictors associated with subclinical micronutrient deficiency included very old age, physical inactivity, frailty and no/irregular use of supplements. Subclinical micronutrient deficiency is a public health concern among KORA-Age participants, especially for vitamins D and B 12 . The predictors identified provide further rationale for screening high-risk subgroups and developing targeted public health interventions to tackle prevailing micronutrient inadequacies among older adults.

Healthy ageing: the natural consequences of good nutrition—a conference report

“…Using data from the National Health and Nutrition Examination Survey (NHANES), 6.9% of US adults aged 51–70 years and 15% of those over 70 years are B12 deficient [ 17 ]. Similar findings were reported in Germany, with 27.3% of people aged 65–93 having deficient serum B12 levels [ 30 ]. The decline in gastric acid secretion that occurs with advancing age can make it difficult to absorb food-bound B12 in meat, poultry, seafood, dairy, and eggs.…”

Level of vitamin 25 (OH) D and B group vitamins and functional efficiency among the chronically ill elderly in domiciliary care – a pilot study

“…However, there is a lack of a Polish population-wide research of people over 65 in the field of vitamin and micronutrient assessment in the body. In representative German studies, the KORA-Age-Study conducted in a group of people over 65 (n = 1,079, aged 65-93), deficiencies of vitamin 25 (OH) D (<50 nmol / l) were found in 52% of respondents and vitamin B12 (<221 pmol / l) in 27.3% of subjects [13].…”

B12 levels and frailty syndrome

“…Conzade et al (2017) examining data among older adults, aged 65 to 92, from the KORA-Age study in Augsburg, Germany (1079 participants), using serum nutritional biomarkers and multiple logistic regression, concluded that more than a quarter of individuals had low vitamin B12 levels. Furthermore, they revealed that conditions such as aging, lack of physical activity, frailty, no use or irregular use of micronutrient-containing supplements consist common predictors of subclinical micronutrient deficiencies[ 32 ]. Soh et al (2020), in another study among 2938 participants (1400 men and 1538 women) from the Korean Frailty and Aging Cohort Study with mean age of 77.8 years for the frail group and 76.7 for the non-frail group, concluded that low B12 levels increased the incidence of frailty and also affected physical performance[ 33 ].…”