| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
American Journal of Clinical Nutrition, Vol 66, 750-759, Copyright © 1997 by The American Society for Clinical Nutrition, Inc
REVIEW ARTICLES |
R Carmel
Department of Medicine, New York Methodist Hospital, Brooklyn 11215, USA. rcarmel@pol.net
Low cobalamin concentrations are common in the elderly. Although only a minority of such persons display clinically obvious symptoms or signs, metabolic data clearly show cellular deficiency of cobalamin in most cases. The evidence suggests that this is not a normal physiologic expression of the aging process. Rather, the elderly seem at increased risk for mild, preclinical cobalamin deficiency. Classical disorders such as pernicious anemia are the cause of this deficiency in only a small proportion of the elderly. A more frequent problem is food- cobalamin malabsorption, which usually arises from atrophic gastritis and hypochlorhydria but other mechanisms seem to be involved in some patients. The diminished absorption should not be viewed as a natural consequence of aging. The partial nature of this form of malabsorption produces a more slowly progressive depletion of cobalamin than does the more complete malabsorption engendered by disruption of intrinsic factor-mediated absorption. The slower progression of depletion probably explains why mild, preclinical deficiency is associated with food-cobalamin malabsorption more often than with pernicious anemia. Decisions about the optimal management of the very common problem of mild, preclinical cobalamin deficiency in the elderly await further clarification of the processes and the complex issues involved, including the possibility that routine nitrous oxide use during surgery, proposed dietary changes, and other practices may further stress the marginal cobalamin status of many elderly people.
This article has been cited by other articles:
|
|
 |
|
  R. Carmel How I treat cobalamin (vitamin B12) deficiency Blood, September 15, 2008; 112(6): 2214 - 2221. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Vollset, J. Igland, M. Jenab, A. Fredriksen, K. Meyer, S. Eussen, H. K. Gjessing, P. M. Ueland, G. Pera, N. Sala, et al. The Association of Gastric Cancer Risk with Plasma Folate, Cobalamin, and Methylenetetrahydrofolate Reductase Polymorphisms in the European Prospective Investigation into Cancer and Nutrition Cancer Epidemiol. Biomarkers Prev., November 1, 2007; 16(11): 2416 - 2424. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Carmel The Disappearance of Cobalamin Absorption Testing: A Critical Diagnostic Loss J. Nutr., November 1, 2007; 137(11): 2481 - 2484. [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Morris, P. F Jacques, I. H Rosenberg, and J. Selhub Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification Am. J. Clinical Nutrition, January 1, 2007; 85(1): 193 - 200. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J Eussen, L. C de Groot, L. W Joosten, R. J Bloo, R. Clarke, P. M Ueland, J. Schneede, H. J Blom, W. H Hoefnagels, and W. A van Staveren Effect of oral vitamin B-12 with or without folic acid on cognitive function in older people with mild vitamin B-12 deficiency: a randomized, placebo-controlled trial. Am. J. Clinical Nutrition, August 1, 2006; 84(2): 361 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Vitamin Supplements Obstet. Gynecol., January 1, 2006; 107(1): 174 - 176. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Dhonukshe-Rutten, M. van Zutphen, L. C. de Groot, S. J. Eussen, H. J Blom, and W. A van Staveren Effect of supplementation with cobalamin carried either by a milk product or a capsule in mildly cobalamin-deficient elderly Dutch persons Am. J. Clinical Nutrition, September 1, 2005; 82(3): 568 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Morris, D. A. Evans, J. L. Bienias, C. C. Tangney, L. E. Hebert, P. A. Scherr, and J. A. Schneider Dietary Folate and Vitamin B12 Intake and Cognitive Decline Among Community-Dwelling Older Persons Arch Neurol, April 1, 2005; 62(4): 641 - 645. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Bailey Folate, Methyl-Related Nutrients, Alcohol, and the MTHFR 677C->T Polymorphism Affect Cancer Risk: Intake Recommendations J. Nutr., November 1, 2003; 133(11): 3748S - 3753. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Campbell, J. W. Miller, R. Green, M. N. Haan, and L. H. Allen Plasma Vitamin B-12 Concentrations in an Elderly Latino Population Are Predicted by Serum Gastrin Concentrations and Crystalline Vitamin B-12 Intake J. Nutr., September 1, 2003; 133(9): 2770 - 2776. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Johnson, N. A Hawthorne, W. R Brackett, J. G Fischer, E. W Gunter, R. H Allen, and S. P Stabler Hyperhomocysteinemia and vitamin B-12 deficiency in elderly using Title IIIc nutrition services Am. J. Clinical Nutrition, January 1, 2003; 77(1): 211 - 220. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Carmel, R. Green, D. S. Rosenblatt, and D. Watkins Update on Cobalamin, Folate, and Homocysteine Hematology, January 1, 2003; 2003(1): 62 - 81. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Niyikiza, S. D. Baker, D. E. Seitz, J. M. Walling, K. Nelson, J. J. Rusthoven, S. P. Stabler, P. Paoletti, A. H. Calvert, and R. H. Allen Homocysteine and Methylmalonic Acid: Markers to Predict and Avoid Toxicity from Pemetrexed Therapy Mol. Cancer Ther., May 1, 2002; 1(7): 545 - 552. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. McKinley, J.J. Strain, J. McPartlin, J. M. Scott, and H. McNulty Plasma Homocysteine Is Not Subject to Seasonal Variation Clin. Chem., August 1, 2001; 47(8): 1430 - 1436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L. Carpenter and E. D. Patalas Case 40-2000- A 38-Year-Old Woman with Gastric Adenocarcinoma N. Engl. J. Med., December 28, 2000; 343(26): 1951 - 1958. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Stopeck Links Between Helicobacter pylori Infection, Cobalamin Deficiency, and Pernicious Anemia Arch Intern Med, May 8, 2000; 160(9): 1229 - 1230. [Full Text] [PDF]
|
|
|
|
|
|
K. L Tucker, S. Rich, I. Rosenberg, P. Jacques, G. Dallal, P. W. Wilson, and J. Selhub Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring Study1 Am. J. Clinical Nutrition, February 1, 2000; 71(2): 514 - 522. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Carmel, R. Green, D. W Jacobsen, K. Rasmussen, M. Florea, and C. Azen Serum cobalamin, homocysteine, and methylmalonic acid concentrations in a multiethnic elderly population: ethnic and sex differences in cobalamin and metabolite abnormalities Am. J. Clinical Nutrition, November 1, 1999; 70(5): 904 - 910. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. G. van Walraven and C. D. Naylor Use of vitamin B12 injections among elderly patients by primary care practitioners in Ontario Can. Med. Assoc. J., July 1, 1999; 161(2): 146 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Z Stolzenberg-Solomon, E. R Miller III, M. G Maguire, J. Selhub, and L. J Appel Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population Am. J. Clinical Nutrition, March 1, 1999; 69(3): 467 - 475. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
