SERUM FOLATE AND VITAMIN‐B 12 LEVELS IN THE ELDERLY

124

The vitamin profile of 473 elderly persons was compared with that of 204 healthy volunteers (controls). Of the 473 elderly, 327 (mean age 87) lived in nursing homes, and 146 (mean age 77) lived at home. The 204 controls were in the 20–50 year age group. The circulating levels of biotin, pantothenate, riboflavin, vitamins A, B6, B12, C, E, folate, thiamine, nicotinate, and carotenes were determined in all groups. Hypovitaminemia was not obvious for biotin, pantothenate, riboflavin, vitamins A, E, and carotenes in either the institutional or non‐institutional elderly. Thiamine, vitamin C and vitamin B12 levels were strikingly depressed in the non‐institutional elderly as compared with the institutional population or the controls. Over 30 percent of the institutional elderly had vitamin B6 and nicotinate hypovitaminemia compared to the controls. Both the institutional and the non‐institutional elderly showed depressed levels of folate and vitamin B12. Vitamin supplementation reduced the percentage of folate and B12 deficits. The marked vitamin deficits in the institutional population, in descending order of incidence were: vitamin B6, nicotinate, vitamin B12, folate, thiamine, and ascorbate, whereas the pattern for the non‐institutional elderly was: vitamin B12, thiamine, ascorbate, vitamin B6, nicotinate, and folate. In the 473 elderly studied, vitamin B6, nicotinate, and vitamin B12, in that order, were the most common deficits; folate, thiamine and ascorbate deficits comprised a lesser percentage. The role of vitamin deficits and the effects upon the aging population are discussed.

Section: Discussionmentioning

confidence: 59%

Vitamin Profiles in Elderly Persons Living at Home or in Nursing Homes, versus Profile in Healthy Young Subjects

Baker¹,

Frank²,

Thind³

et al. 1979

124

“…Whereas some investigators have reported that serum vitamin B 12 levels are relatively constant throughout life, 50–52 others have found decreasing levels with increasing age 53–55 . However, none of these studies controlled for the presence of atrophic gastritis.…”

Section: Discussionmentioning

confidence: 99%

Fundic Atrophic Gastritis in an Elderly Population: Effect on Hemoglobin and Several Serum Nutritional Indicators

Krasinski

Russell

Samloff

et al. 1986

209

The ratio of pepsinogen I to pepsinogen II in the circulation decreases progressively with increasing severity of atrophic gastritis of the fundic gland mucosa. Fasting blood was obtained from 359 free-living and institutionalized elderly people (age range, 60 to 99 years). A pepsinogen I/pepsinogen II ratio less than 2.9, indicating atrophic gastritis, was found in 113 (31.5%) subjects. The prevalence of atrophic gastritis increased significantly with advancing age (P less than .05). Within the atrophic gastritis group, 84 had a pepsinogen I level greater than or equal to 20 micrograms/L, indicating mild to moderate atrophic gastritis, and 29 had a pepsinogen I level less than 20 micrograms/L, indicating severe atrophic gastritis or gastric atrophy. A significant increase in the prevalences of elevated serum gastrin levels (P less than .005), low serum vitamin B12 levels (P less than .005), circulating intrinsic factor antibody (P less than .005), and anemia (P less than .025) was observed with stepwise increases in severity of atrophic gastritis. Subjects with atrophic gastritis exhibited a lower mean serum vitamin B12 level (P less than .05) and a higher mean folate level (P less than .05), but no difference was detected in mean hemoglobin levels or serum levels of iron, ferritin, retinol or alpha-tocopherol. It is concluded that serum pepsinogen I and pepsinogen II levels can be used to determine the prevalence and severity of atrophic gastritis, that atrophic gastritis is common in an elderly population, and that atrophic gastritis is associated with vitamin B12 deficiency and anemia. Further, higher folate levels in atrophic gastritis may be related to an accumulation of 5-methyl tetrahydrofolate in serum due to vitamin B12 deficiency and/or greater folate synthesis by the intestinal flora resulting from bacterial overgrowth secondary to hypo- or achlorhydria.

“…However, findings concerning serum B 12 and serum erythrocyte folate concentration in the aged have varied. Some investigators have found a decrease in the serum vitamin B 12 level in the aged 19,20 whereas others have found that the serum B 12 level remains constant throughout life 21,22 . Similarly, in some studies, measurements of serum and erythrocyte folate concentration in the aged have shown that the level is unchanged, 21,23 whereas in other studies these concentrations have been shown to decrease with age 24–25 .…”

Section: Discussionmentioning

confidence: 99%

Erythrocyte Aging Changes Evaluated by the Deoxyuridine Suppression Test

Okabe

Ishizawa

Ishii

et al. 1982

Many hematologic studies have shown that the erythrocyte count decreases while the size of the individual cell increases in the aged. This study was performed in order to (1) evaluate changes in the blood erythrocyte level and mean erythrocyte size in the elderly and (2) evaluate use of the deoxyuridine (dU) supression test to determine whether deficiency of vitamin B12 or folate plays any role in age-related changes of hematopoiesis. Selected for study were 102 healthy men whose ages ranged from 20 to 79 years. The erythrocyte count and hemoglobin level decreased significantly, whereas the mean corpuscular volume and mean corpuscular hemoglobin increased after 70 years of age. Fresh bone-marrow cells were obtained from 10 young (20-38 yr) and 10 aged (70-82 yr) men. Wickramasinghe's dU suppression test was modified by application of an automatic cell harvester. The results were normal in both groups. Thus, the route of dU to dTMP in a DNA synthetic pathway appeared intact, and there was no evidence of B12 or folate deficiency in the aged to explain the observed macrocytosis. However, 3H-thymidine uptake by nucleated bone-marrow cells was significantly decreased, and the ratio of 3H-uridine to 3H-thymidine uptake was greater in the old group than in the young group. These results could be explained by altered nucleic acid metabolism (unbalanced cell growth) or by a change in the proportion of the different fractions of nucleated cells.