High Prevalence of Cobalamin Deficiency in Elderly Outpatients

The prevalence of cobalamin deficiency as defined by a serum cobalamin level ≤300 pg/mL and levels of serum methylmalonic acid and/or homocysteine elevated to >3 standard deviations was 14.5% of the screened outpatients

Leslye C. Pennypacker

2015

Scholarcy highlights

  • The prevalence of cobalamin deficiency as defined by a serum cobalamin level ≤300 pg/mL and levels of serum methylmalonic acid and/or homocysteine elevated to >3 standard deviations was 14.5% of the screened outpatients
  • Results for complete blood count, lactate dehydrogenase, bilirubin, baseline neurologic score, and baseline neuropsychologic scores did not differ in the group of patients with elevated metabolites compared with those with normal metabolites
  • There was a high prevalence of cobalamin deficiency as demonstrated by elevations in serum methylmalonic acid and homocysteine in addition to low or low normal serum cobalamin levels in elderly outpatients
  • The serum cobalamin level was insensitive for screening since similar numbers of patients with low normal serum cobalamin levels of 201–300 pg/mL compared with patients with low cobalamin levels had markedly elevated metabolites which fell with cobalamin treatment
  • Additional studies will be required to define the full clinical benefit from treatment with Cbl in elderly subjects

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