Folate status worsens in recently institutionalized elderly people without evidence of functional deterioration.
OBJECTIVE
To follow folate status, hematological and cognitive changes during the first year of institutionalization among elderly subjects.


METHODS
Prospective study.


METHODS
Long-stay unit of the Dijon University Geriatric Hospital.


METHODS
Twenty women and four men older than 65 years admitted consecutively.


METHODS
Folate and vitamin B-6 dietary intake was evaluated by a five-day record on admission (day 1 or d 1), at day 45 (d 45), day 90 (d 90), day 135 (d 135), day 180 (d 180), day 360 (d 360). Circulating levels of folate, vitamin B-6, total homocysteine (tHcy), blood counts and cognitive performance were determined in parallel.


RESULTS
From d 1 to d 360, mean folate and vitamin B-6 intakes remained below the French RDA and mean folate intakes decreased significantly (delta = 10.2%, p < 0.05). Mean plasma or erythrocyte folate decreased significantly (delta = 33.7%, p <0.05 and delta = -30.2%, p < 0.001, respectively) from d 1 to d 360; no significant change was observed for the other blood parameters. The incidence of folate deficiency increased (8% vs. 37% for plasma folate <6.8 nmol/L and 8% vs. 17% for erythrocyte folate <340 nmol/L) from d I to d 360. Mean plasma pyridoxal 5'-phosphate (PLP) remained <20 nmol/L during the one-year follow-up. There was no difference between genders for plasma tHcy. Although mean plasma tHcy was <14 micromol/L. plasma tHcy was >14 micromol/L in about one-third of the subjects. At each period, 50% or more subjects were anemic (Hct <35% in women and Hct <40% in men), but the anemia was normocytic (MCV <100 fL). Subjects had a moderate dementia at admission, and no change was observed during the study.


CONCLUSIONS
Subjects were already vitamin B-6 deficient at admission. Folate status was impaired during the study. Low vitamin intakes were the main cause of vitamin B-6 deficiency and folate status deterioration. Hematology and mental status capacity were not aggravated by folate status deterioration. Plasma tHcy didn't appear to be an earlier predictor of folate deficiency.
Essama-Tjani
J C
JC
Laboratoire de Physiologie, Faculté de Médecine, Dijon, France.
Guilland
J C
JC
Potier de Courcy
G
G
Fuchs
F
F
Richard
D
D
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D015930:Diet Records; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood / Q000187:drug effects / Q000494:pharmacology; D005494:Folic Acid Deficiency / Q000097:blood / Q000188:drug therapy*; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007326:Institutionalization; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies; D011736:Pyridoxine / Q000008:administration & dosage* / Q000097:blood / Q000494:pharmacology
D006710:Homocysteine; D005492:Folic Acid; D011736:Pyridoxine