An investigation of vitamin B12 deficiency in elderly inpatients in neurology department.
OBJECTIVE
To investigate the status of vitamin B12 deficiency in elderly inpatients in the department of neurology.


METHODS
A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1+/-7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B12 during the previous 3 months before the detection. The levels of serum vitamin B12, folate and homocysteine (Hcy) were evaluated. The patients with vitamin B12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B12 deficiency.


RESULTS
Vitamin B12 deficiency was found in 163 patients (19.71% of the total patients), and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B12 deficient patients had megaloblastic anemia. Symptoms of vitamin B12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson's disease (Parkinsonism), diabetes mellitus and coronary heart disease. Most of the vitamin B12 deficient patients had neuroelectricphysiological abnormalities.


CONCLUSIONS
Vitamin B12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.
Wang
Yu-Hui
YH
Department of Neurology, Shanghai Punan hospital, Shanghai 200125, China. yhwangch@sina.com
Yan
Fang
F
Zhang
Wen-Bo
WB
Ye
Gang
G
Zheng
Yun-Yun
YY
Zhang
Xu-Hua
XH
Shao
Fu-Yuan
FY
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000749:Anemia, Megaloblastic / Q000209:etiology; D004594:Electrophysiology; D005260:Female; D005492:Folic Acid / Q000097:blood; D015577:Geriatric Assessment; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009752:Nutritional Status; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013223:Statistics as Topic; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*
D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12