Chapter 16

Vitamin B12 Deficiency in the Elderly

Chit Wai Wong,    Caritas Medical Centre, Kowloon, Hong Kong


Vitamin B12 deficiency is common among the elderly, and the institutionalized elderly seem to be particularly at risk. Food-cobalamin malabsorption due to the inability to release vitamin B12 from food is a more common cause of vitamin B12 deficiency in the elderly than pernicious anemia. Clinical manifestations are highly variable and often subtle and nonspecific. The classical finding of macrocytic anemia may not be present even in the presence of a neuropsychiatric disorder. Diagnosis of vitamin B12 deficiency, however, is not straightforward because laboratory tests have limitations. Although vitamin B12 replacement is safe ...

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