High prevalences of vitamin B12 and folic acid deficiency in elderly subjects in Israel

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Abstract
Summary.  The prevalences of vitamin B12 and folic acid deficiency in the general Israeli population of elders has not been assessed. We measured plasma cobalamin and folic acid concentrations in 418 subjects from four institutions for the aged, 749 subjects attending 19 geriatric day centres and 104 healthy controls. Methylmalonic acid (MMA) and/or homocysteine concentrations were determined in subjects who had a cobalamin concentration 12 deficiency (cobalamin μmol/l), and folic acid deficiency (folic acid 15 μmol/l) in subjects from day centres were 12·6% and 16·4% respectively, and in subjects from institutions 1·2% and 2·2% respectively (P < 0·001). Multiple logistic regression analysis indicated that the relative risk of living at home versus institutions for the aged was highly significant, with odds ratios (OR) of 6·8 [95% confidence interval (CI) 2·6–18·0] for vitamin B12 deficiency and 6·6 (95% CI 2·9–13·1) for folic acid deficiency. Analysis of data for day centre patients showed that folic acid deficiency was a significant risk factor of vitamin B12 deficiency (adjusted OR 3·68, 95% CI 2·27–5·98), and vitamin B12 deficiency was a significant risk of folic acid deficiency (adjusted OR 3·69, 95% CI 2·27–6.01). These data suggest that malnutrition is a major cause of the highly prevalent deficiencies of vitamin B12 and/or folic acid in elderly Israeli subjects dwelling at home.