Razi Journal of Medical Sciences

     Background & Aim: Owing to decreased absorption of cobalamin in the elderly, cobalamin deficiency is a common problem in these subjects. On the other hand, insufficient vitamin B12 status may increase the incidence of atherosclerotic and neurodegenerative disorders. Recently investigators have recommended B12 monitoring in the elderly and detecting at risk subjects in the early stages of deficiency.

 The purpose of this study is to assess serum levels of B12, folate and homocysteine in the healthy Iranian elderly and to find a probable relation between them.

 Patients and Method: This project was conducted as a cross-sectional study in Tehran. A total of 232 people aged 65-90 years, with a mean of 73 years, were recruited and data was gathered by measuring serum levels of homocysteine, folate, and vitamin B12, interview and physical examination. Blood samples were gathered and analyzed according to standard methods. Statistical analysis was done using SPSS 11. 5 software. Comparison of values were made using Chi-square and Students' t-test. The p-value of less than 0. 05 was determined significant.

 Results: The variables were assessed in 102(44%) male and 130(56%) female subjects. The mean of serum B12 was 295 pg/ml (SD±170). 10% of cases had B12 levels less than 119 and 18% less than 160 pg/ml. B12 deficiency increased with ageing (p=0. 000),but there was not a significant relation with sex (p=0. 85). The mean of folate level was 8 ng/ml (SD±4. 9). 9. 5% of cases had folate levels below normal range without a significant relation to age (p=0. 06) or sex (p=0. 31). The mean of homocysteine (Hcy) concentration was 19. 3 μmol/l (SD±7. 1). Homocysteine values were more than 20 μmol/l in 33. 6% and more than 15 μmol/l in 67% of the subjects with no relation to ageing (p=0. 23). 42. 2% of males and 27. 7% of females had homocysteine values more than 15 μmol/l (p=0. 005),which was statistically significant. Correlation coefficients between the levels of homocysteine, serum B12 and folate indicated a significant inverse correlation (r = -0. 33, p= 0. 000 r = -0. 20, p=0. 002 respectively).

 Conclusion: The results of this study show that the incidence of hyperhomocysteinemia, B12 and folate deficiency in the elderly is not lower than developed countries, and B12 deficiency seems to be functionally higher than western countries. It is suggested that the elderly use vitamin B group as medication or as fortified foods regularly.