Among the elderly, a wrong intake of Vitamin B12 and folate are common, often causing deficiencies. To confirm recent Irish research, the Irish Longitudinal Study on Aging (TILDA).
It is a multidisciplinary study, which involved people aged 50 and over, focusing on the health, economic and social situation of the elderly to understand the determinants of aging, the first signs that identify the process, inform the institutions and trace the effectiveness of their interventions.
The mandatory fortification of basic cereals with folic acid and/or Vitamin B12 (B12) is the subject of debate in many countries, including Ireland, which has a liberal but voluntary fortification policy. The study shows that unfortunately, a voluntary fortification is not sufficient to guarantee an adequate intake of these substances (Laird EJ et al.
Voluntary fortification is ineffective to maintain the vitamin B12 and folate status of older Irish adults: evidence from the Irish Longitudinal Study (TILDA). British Journal of nutrition. 201; 120 (1): 111-120). The results show a significant deficiency in the over 50 population: 12% of the subjects analyzed were deficient for Vitamin B12 (<185 pmol / l), 15% for Folate.
To understand who may be most at risk, some factors have also been analyzed, such as demographic, socio-economic, geographical, seasonal and health/lifestyle factors, which understand how these elements can be correlated with vitamin levels.
As expected, the greatest positive predictor of good Vitamin B12 concentrations was the habit of supplementation. The major negative predictive factor was instead the use of metformin (a drug for diabetes that reduces the absorption of B12). Similarly, the major positive predictor of Folate concentration was the use of folic acid supplements. On the other hand, there were negative predictive factors such as geographical location, seasonality, and smoking. Vitamin B status in the elderly is influenced by health, lifestyle, medications, sampling period and geographical location. The research has observed a high prevalence of low blood concentrations of B12 and folate, and this underlines the importance of the management of fortification with such substances not being left only on a voluntary basis, at least for the elderly. A useful solution could be the fortification of the flour, but this does not replace the need for the elderly to undergo monitoring through regular blood tests and to resort to integration when necessary.
Vitamin B12 deficiency in the elderly
In the elderly, the most frequent causes of Vitamin B12 deficiency are poor dietary protein intake, reduction of gastric acid secretion and gastric infection with Helicobacter pylori.
In case of deficiency, hematological signs and symptoms, such as anemia, and neurological signs, such as numbness in the extremities, changes in sensitivity, difficulty in walking and mental confusion may occur.
Furthermore, B12, together with folic acid, is involved in important mechanisms such as the metabolism of homocysteine, a metabolite that, if present in high quantities, can determine an increase in cardiovascular risk, and arteriosclerosis.
Folic acid deficiency
Folic acid is an important nutrient for various physiological functions, for example, it is essential for the synthesis of DNA and proteins and for the formation of hemoglobin, and is particularly important for tissues that undergo proliferation and differentiation processes. A correct contribution is therefore important to protect health. And its lack, among other things, can lead to anemia and generalized exhaustion. It is important to know that certain situations can lead to a decreased absorption of folic acid from the diet, such as the chronic use of some drugs, high consumption of alcohol, and celiac disease.
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