Cobalamin Deficiency in the Elderly.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or meta-analysis.
PubMed 32670521 · doi:10.4084/MJHID.2020.043
What was done
This narrative review summarizes the physiology, risk factors, diagnostic difficulties, clinical consequences, and treatment modalities for cobalamin (vitamin B12) deficiency, focusing specifically on older adults.
What was found
The abstract reports no numerical data. Qualitatively, it highlights that cobalamin deficiency prevalence rises with age and frailty, serum vitamin B12 testing lacks sensitivity and specificity, and adjunctive markers (homocysteine and methylmalonic acid) are constrained by cost, availability, and confounders such as renal dysfunction. It also notes that high-dose oral cobalamin achieves outcomes equivalent to parenteral administration, even in patients with malabsorption.
Why it matters
It provides a clinical synthesis of diagnostic pitfalls in older individuals and reinforces high-dose oral repletion as a non-invasive, effective alternative to intramuscular injections.
Limits
As a narrative review, it presents no original data, pooled quantitative estimates, or formal systematic screening methodology. Specific test accuracy parameters, dosing regimens, and prevalence statistics are omitted in the abstract.
Cited by
- supports The human body's capacity to absorb vitamin B12 decreases with age.