Age and Ageing Advance Access originally published online on May 18, 2006
Age and Ageing 2006 35(4):416-422; doi:10.1093/ageing/afl033
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Clinical relevance of low serum vitamin B12 concentrations in older people: the Banbury B12 study
1 Hightown Surgery, Hightown Gardens, Banbury, UK
2 Clinical Trial Service Unit, University of Oxford, Richard Doll Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK
3 Department of Haematology, Oxford Radcliffe Hospitals NHS Trust, Banbury, UK
4 Division of Clinical Geratology, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
5 Department of Clinical Chemistry, Umeå University Hospital, Umeå, Sweden
6 Locus for Homocysteine and Related Vitamins, University of Bergen, Bergen, Norway
7 Department of Clinical Biochemistry, AS, Aarhus University Hospital, Aarhus, Denmark
8 Department of Biochemistry, Trinity College, Dublin, Ireland
9 Department of Clinical Neurology, University of Oxford, Oxford, UK
10 Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK
Address correspondence to: Robert Clarke. Tel: (+44) 1865 743743. Fax: (+44) 1865 743985. Email: robert.clarke{at}ctsu.ox.ac.uk
Background: low vitamin B12 concentrations are common in older people, but the clinical relevance of biochemical evidence of vitamin B12 deficiency in the absence of anaemia is uncertain.
Objective: to examine associations of cognitive impairment, depression and neuropathy with blood measurements of vitamin B12 and folate status in older people.
Design: cross-sectional study in general practice in Banbury, England.
Participants: a total of 1,000 individuals aged 75 years or older living in the community.
Results: low vitamin B12 concentrations were identified in 13% of older people and were associated with memory impairment and depression. After adjustment for age, sex and smoking, individuals with vitamin B12 or holotranscobalamin (holoTC) in the bottom compared with top quartiles had a 2-fold risk (OR = 2.17; 95% CI 1.11–4.27) and a 3-fold risk (OR = 3.02; 95% CI 1.31–6.98) of cognitive impairment, respectively. Low vitamin B12 status was also associated with missing ankle tendon jerks but not with depression. Treatment with vitamin B12 for 3 months corrected the biochemical abnormalities but had no effect on any of the clinical measurements.
Conclusions: low vitamin B12 concentrations are associated with cognitive impairment and missing ankle tendon jerks in older people in the absence of anaemia. Large-scale trials of vitamin B12 supplementation are required to assess the clinical significance of these associations.
Keywords: vitamin B12, cognitive impairment, depression, neuropathy
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