title: Older adult psychiatric inpatients with non-cognitive disorders should be screened for vitamin B12 deficiency.
abstract: OBJECTIVE
  Vitamin B12 (B12) deficiency is most prevalent among older adults. Practice guidelines recommend screening older adults with symptoms of cognitive disorder for B12 deficiency. However, guidelines for non-cognitive psychiatric disorders typically do not mention screening older adults for B12 deficiency. The purpose of this study was to determine whether routine screening of older adult psychiatric inpatients for B12 deficiency, regardless of cognitive symptoms, is clinically justified.
  
  
  METHODS
  We conducted a retrospective chart-review study of consecutive inpatient admissions.
  
  
  METHODS
  Older Adult Acute Psychiatric Inpatient Unit at the University of Maryland Medical Center from 10/2007-4/2010.
  
  
  METHODS
  Acute psychiatric inpatients aged ≥50 years who met inclusion criteria (N=374).
  
  
  METHODS
  Mean (SD) B12 levels and percentages of probable (<180pg/mL) and possible (180-350pg/mL) B12 deficiency as well as characteristics of patients with probable and possible B12 deficiency compared to patients with optimal B12 levels.
  
  
  RESULTS
  Mean (SD) B12 levels and percentages of probable and possible B12 deficiency, respectively, for cognitive disorder patients [468 (284) pg/mL, 7.8 % (n=5) and 29.7% (n=19)] and for non-cognitive disorder patients [481(268) pg/mL, 4.8 %(n=15) and 33.2%( n=103)] were not significantly different (t=0.339, df=372, P=0.735; χ2=1.084, df=2, P=0.582, respectively).
  
  
  CONCLUSIONS
  Considering the potential benefits and low costs of screening and treatment, we conclude that it is justified to routinely screen older adult psychiatric inpatients for B12 deficiency whether or not cognitive disorder symptoms are present.
authors: William T. Regenold, M.D.C.M, Associate Professor, Director, Division of Geriatric Psychiatry, University of Maryland Medical Center, Department of Psychiatry S12A09, 22 South Greene St. Baltimore, MD 21201, P. (410) 328-6511, Fax. (410) 328-5584, wregenol@psych.umaryland.edu.
authors: C
authors: C
authors: Lachner
authors: C
authors: C
authors: Martin
authors: D
authors: D
authors: John
authors: S
authors: S
authors: Nekkalapu
authors: A
authors: A
authors: Sasan
authors: N
authors: N
authors: Steinle
authors: W T
authors: WT
authors: Regenold
mesh_terms: D000368:Aged; D003071:Cognition; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000097:blood* / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014805:Vitamin B 12 / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis*
chemical_list: D014805:Vitamin B 12