Vitamin B12 deficiency damages nerve cells and aggravates nervous system disorders even in the absence of evidence of anaemia. Prevalence of B12 deficiency increases with age especially over 65 and is frequently associated with Alzheimer's disease. Recent American surveys record a higher prevalence of B12 deficiency and of undiagnosed and untreated pernicious anaemia in the elderly than reported earlier. B12 deficiency is also reported to be a risk factor for heart disease, stroke and accelerated ageing.
HealtonE.B.SavageD.G.BrustJ.C.M.GarnettT.J.LindenbaumJ.Neurologic aspects of cobalamin deficiency. Medicine1991; 70, 2339–45.
2.
MarcusD.L.ShadickN.CrantzJ.GrayM.HernandezF.FreedmanM.L.Serum B12 levels in a hematologically normal elderly sub-population. J Am Geriatr Soc1987, 35, 635–8.
3.
NormanE.J.MorrisonJ.A.Screening elderly populations for cobalamin (B 12) deficiency using the urinary methylmalonic acid assay by gas chromatography mass spectrometry. Am. J. Med.1993, 94, 589–94.
4.
AllenL.H.CasterlineJ.Vitamin B12 deficiency in elderly individuals: diagnosis and requirements. Am. J. Clin. Nutr.1994, 60, 12–4.
5.
Public Law 101–58 101st Congress, Joint Resolution. Decade of the Brain. Congressional Record, 1998, vol. 135.
6.
OttA.BretelerM.M.B.van HarskampF.ClausJ.J.. Prevalence of Alzheimer's disease and vascular dementia: The Rotterdam Study. BMJ, 1995, 310, 970–3.
WeinerM.A.Reducing the risk of Alzheimers. London: Gateway, 1989.
10.
ColeM.G.PrchalJ.F.Low serum vitamin B12 in Alzheimer-type dementia. Age Ageing, 1984, 13, 101–5.
11.
JoostenE.LesaffreE.RiezlerR.. Is metabolic evidence for vitamin B12 and folate deficiency more frequent in elderly patients with Alzheimer's disease?J. Gerontol, 1990, 52, M76–M79.
12.
KristensenM.O.GulmannN.C.ChristensenJ.E.J.OstergaardK.RasmussenK.Serum cobalamin and methylmalonic acid in Alzheimer dementia. Acta Neurol Scand.1993, 87, 475–81.
13.
FataF.T.HerzlichB.C.SchiffmannG.AstA.L., Impaired antibody response to pneumococcal polysacharide in elderly patients with low serum vitamin B12 levels. Ann Intern Med.1996, 124, 299–304.
14.
PennypackerL.C.AllenR.H.KellyJ.P.. High prevalence of cobalamin deficiency in elderly out-patients. J. Am. Geriatr. Soc.1992, 40, 1197–1204.
15.
StablerS.P.Screening the elderly population for cobalamin (B12) deficiency, J. Am. Geriatr. Soc.1995, 43, 1290–7.
16.
LindenbaumJ.RosenbergI.H.WilsonP.W.F.StablerS.P.AllenR.H.Am. J. Clin Nutr.1994, 60, 2–11.
17.
GregoryJ.FosterK.TylerH.WisemanM.The dietary and nutritional survey of British adults. London: HMSO, 1990.
18.
HerbertV.Vitamin B12. In: ZieglerE.E.FilerL.J., eds. Present knowledge in nutrition. 7th edition. Washington DC: ILSI Press, 1996, 191–205.
19.
HerbertV.BigaouetteJ.Call for endorsement of a petition to the Food and Drug Administration to always add vitamin B12 to any folate fortification or supplementation. Am. J. Clin. Nutr.1997, 65, 572–3.
20.
FraserR.C.FarooqiA.SorrieR.Use of vitamin B12 in Leicestershire practices; a single topic audit led by a medical audit advisory group. BMJ, 1995, 311, 28–30.
21.
FraserR.C.CathcartM.SeivewrightH.Audit of the use of vitamin B12 in general practice. BMJ, 1983; 287, 729–31.
22.
CochraneA.L.MooreF.Expected and observed values for the prescription of vitamin B12 in England and Wales. Brit J. Prev. Soc. Med.1971, 25, 147–51.
LindenbaumJ.HealtonE.B.SavageD.G.. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anaemia or macrocytosis. New Eng. J. Med.1988, 316, 1720–8.
25.
GrahamJ.What is multiple sclerosis?London: Multiple Sclerosis Society of Great Britain and Northern Ireland, 1996.
26.
KimS.ChanderkarL.P.GhoshS.K.Protein-arginine methylation: myelin basic protein as a model. In: PaikW.K.KimS., eds. Protein methylation. Boca Raton: CRC Press1990, 77–95.
27.
WeirD.G.ScottJ.M.The biochemical basis of the neuropathy of cobalamin deficiency. In: WickramasingheSN, ed. Megaloblastic anemia. Bailliere's Clin. Haematol. 1995, 8, no. 3, 479–97.
28.
DuncanI.D.SkoffR.P.ColmanD., eds. Myelination and dysmyelination. Ann. NY Acad. Sci., 1990, 605, 1–461.
29.
UnderwoodL.E.ClemmonsD.R.MaesM.D'ErcoleA.J.KetelslegersJ.M.Regulation of somatomedin-C/insulin-like growth factor 1 by nutrients. Hormone Res.1986, 24, 166–76.
30.
McMorrisF.A.MozellR.L.CarsonM.J.ShinarY.MeyerR.D.MarchettiN.Regulation of oligodendrocyte development and central nervous system myelination by insulin-like growth factors. Ann NY Acad Sci.1993, 692, 321–34.
31.
ReynoldsE.H.BottiglieriT.LaundyM.CrellinR.F.KirkerS.G.Vitamin B12 metabolism in multiple sclerosis. Arch Neurol.1992, 49, 649–52.
32.
GarryP.J.VellasB.J.Aging and nutrition. In: ZieglerE.E.FilerL.J., eds. Present knowledge in nutrition, 7th edition. Washington DC: ILSI Press, 1996.
33.
MoghadasianM.H.McManusB.M.FrohlichJ.J.Homocysteine and coronary heart disease. Arch Intern. Med.1997, 157, 2299–2308.
34.
Committee on Diet and Health. Diet and health; implications for reducing chronic disease risk. National Research Council. Washington DC: National Academy Press, 1989.
35.
KaplanH.S.RiglerL.G.Pernicious anemia and carcinoma of the stomach; autopsy studies concerning their interrelationship. Am. J. Med. Sci.1945, 209, 339–48.
36.
ArvanitakisC.HolmesF.F.HeameE.A possible association of pernicious anemia with neoplasia. Oncology, 1979, 36, 127–9.
37.
EtoI.KrumdieckC.L., Role of vitamin B12 and folate deficiencies in carcinogenesis. In: PoirierL.A.NewberneP.M.ParizaM.W., eds. Essential nutrients in carcinogenesis. Adv. Exp. Med. Biol., 1986, 206, 313–27.
38.
MacGregorJ.T.WehrC.M.HiattT.A.. Spontaneous genetic damage in man; evaluation of interindividual variability, relationship among markers of damage, and influence of nutritional status. Mut Res, 1997, 377, 125–35.
CarmelR. Prevalence of undiagnosed pernicious anemia in the elderly. Arch. Intern. Med.1996, 156, 1097–1100.
41.
National Research Council. Recommended dietary allowances. 10th edition. Washington DC: National Academy Press, 1989.
42.
VerhaeverbekeI.MetsT.MulkensK.VandewoudeM.Normalization of low vitamin B12 serum levels in older people by oral treatment. J. Am. Geriatr. Soc.1997, 45, 124.
43.
StablerS.P.LindenbaumJ.AlIenR.H.Vitamin B12 deficiency in the elderly; current dilemmas. Am. J. Clin. Nutr.1997, 66, 741–9.
44.
WynnM.WynnA.Fortification of grain products with folate: Should Britain follow the American example?Nutrition and Health, 1998, 12, 147–161.
45.
Ministry of Agriculture, Fisheries and Food. The Food Standards Agency, CM3830. London: HMSO, 1998.