Vitamin B12 (cobalamin) deficiency in elderly patients.
Vitamin B12 or cobalamin deficiency occurs frequently (> 20%) among elderly people, but it is often unrecognized because the clinical manifestations are subtle; they are also potentially serious, particularly from a neuropsychiatric and hematological perspective. Causes of the deficiency include, most frequently, food-cobalamin malabsorption syndrome (> 60% of all cases), pernicious anemia (15%-20% of all cases), insufficient dietary intake and malabsorption. Food-cobalamin malabsorption, which has only recently been identified as a significant cause of cobalamin deficiency among elderly people, is characterized by the inability to release cobalamin from food or a deficiency of intestinal cobalamin transport proteins or both. We review the epidemiology and causes of cobalamin deficiency in elderly people, with an emphasis on food-cobalamin malabsorption syndrome. We also review diagnostic and management strategies for cobalamin deficiency.
Department of Internal Medicine, Medical Clinic B, Strasbourg University Hospitals, Strasbourg, France. emmanuel.andres@chru-strasbourg.fr
Emmanuel
E
Andrès
Noureddine Henoun
NH
Loukili
Esther
E
Noel
Georges
G
Kaltenbach
Maher Ben
MB
Abdelgheni
Anne Elisabeth
AE
Perrin
Marie
M
Noblet-Dick
Frédéric
F
Maloisel
Jean-Louis
JL
Schlienger
Jean-Frédéric
JF
Blicklé
D000368:Aged; D015577:Geriatric Assessment; D006801:Humans; D014805:Vitamin B 12 / Q000378:metabolism / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology
D014805:Vitamin B 12