High prevalences of vitamin B12 and folic acid deficiency in elderly subjects in Israel.
The prevalences of vitamin B12 and folic acid deficiency in the general Israeli population of elders has not been assessed. We measured plasma cobalamin and folic acid concentrations in 418 subjects from four institutions for the aged, 749 subjects attending 19 geriatric day centres and 104 healthy controls. Methylmalonic acid (MMA) and/or homocysteine concentrations were determined in subjects who had a cobalamin concentration <221 pmol/l or folic acid concentration <11 nmol/l respectively. The prevalences of vitamin B12 deficiency (cobalamin <147 pmol/l and MMA > or =0.24 micromol/l), and folic acid deficiency (folic acid <11 nmol/l and homocysteine of >15 micromol/l) in subjects from day centres were 12.6% and 16.4% respectively, and in subjects from institutions 1.2% and 2.2% respectively (P < 0.001). Multiple logistic regression analysis indicated that the relative risk of living at home versus institutions for the aged was highly significant, with odds ratios (OR) of 6.8 [95% confidence interval (CI) 2.6-18.0] for vitamin B12 deficiency and 6.6 (95% CI 2.9-13.1) for folic acid deficiency. Analysis of data for day centre patients showed that folic acid deficiency was a significant risk factor of vitamin B12 deficiency (adjusted OR 3.68, 95% CI 2.27-5.98), and vitamin B12 deficiency was a significant risk of folic acid deficiency (adjusted OR 3.69, 95% CI 2.27-6.01). These data suggest that malnutrition is a major cause of the highly prevalent deficiencies of vitamin B12 and/or folic acid in elderly Israeli subjects dwelling at home.
Figlin
Elizabeth
E
Department of Hematology, Institute of Thrombosis and Hemostasis, Chaim Sheba Medical Centre, Tel-Hashomer, Israel.
Chetrit
Angela
A
Shahar
Avner
A
Shpilberg
Ofer
O
Zivelin
Ariella
A
Rosenberg
Nurit
N
Brok-Simoni
Frida
F
Gadoth
Nathan
N
Sela
Ben-Ami
BA
Seligsohn
Uri
U
D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D016022:Case-Control Studies; D003631:Day Care, Medical; D005260:Female; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D006707:Homes for the Aged; D006801:Humans; D007557:Israel; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D044465:White People
D005492:Folic Acid; D014805:Vitamin B 12