Skip to main content
NCBI home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1985 Oct;38(10):1179–1184. doi: 10.1136/jcp.38.10.1179

Importance of low serum vitamin B12 and red cell folate concentrations in elderly hospital inpatients.

E L Blundell, J H Matthews, S M Allen, A M Middleton, J E Morris, S N Wickramasinghe
PMCID: PMC499465  PMID: 4056070

Abstract

To determine the functional importance of the low B12 and red cell folate concentrations repeatedly observed in the elderly 200 consecutive patients admitted to a geriatric unit were studied. Forty six of the patients had low serum concentrations of B12 (15), red cell folate (26), or both (five). Serum B12 and red cell folate concentrations correlated with mean cell volume, and serum B12 correlated with the neutrophil lobe count. Bone marrow deoxyuridine suppression was abnormal in 35% of the patients with low vitamin concentrations, but 55% of those with abnormal deoxyuridine suppression had morphologically normal bone marrow, and 73% had a normal mean cell volume. In patients with low vitamin values the deoxyuridine suppressed value correlated with the haemoglobin concentration and neutrophil lobe count. Thus synthesis of thymidylate was impaired by vitamin B12 or folate deficiency in at least 8% of newly admitted elderly patients, many of whom had normal blood counts despite the biochemical disturbance affecting haemopoiesis. A nutritionally depleted diet may have been responsible for many of the low vitamin values.

Full text

PDF
1179

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bain B. J., Wickramasinghe S. N., Broom G. N., Litwinczuk R. A., Sims J. Assessment of the value of a competitive protein binding radioassay of folic acid in the detection of folic acid deficiency. J Clin Pathol. 1984 Aug;37(8):888–894. doi: 10.1136/jcp.37.8.888. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bain B., Broom G. N., Woodside J., Litwinczuk R. A., Wickramasinghe S. N. Assessment of a radioisotopic assay for vitamin B12 using an intrinsic factor preparation with R proteins blocked by vitamin B12 analogues. J Clin Pathol. 1982 Oct;35(10):1110–1113. doi: 10.1136/jcp.35.10.1110. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Batata M., Spray G. H., Bolton F. G., Higgins G., Wollner L. Blood and bone marrow changes in elderly patients, with special reference to folic acid, vitamin B12, iron, and ascorbic acid. Br Med J. 1967 Jun 10;2(5553):667–669. doi: 10.1136/bmj.2.5553.667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Girdwood R. H., Thomson A. D., Williamson J. Folate status in the elderly. Br Med J. 1967 Jun 10;2(5553):670–672. doi: 10.1136/bmj.2.5553.670. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hughes D., Elwood P. C., Shinton N. K., Wrighton R. J. Clinical trial of the effect of vitamin B12 in elderly subjects with low serum B12 levels. Br Med J. 1970 May 23;1(5707):458–460. doi: 10.1136/bmj.2.5707.458. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hurdle A. D., Williams T. C. Folic-acid deficiency in elderly patients admitted to hospital. Br Med J. 1966 Jul 23;2(5507):202–205. doi: 10.1136/bmj.2.5507.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Magnus E. M., Bache-Wiig J. E., Aanderson T. R., Melbostad E. Folate and vitamin B12 (cobalamin) blood levels in elderly persons in geriatric homes. Scand J Haematol. 1982 Apr;28(4):360–366. doi: 10.1111/j.1600-0609.1982.tb00539.x. [DOI] [PubMed] [Google Scholar]
  8. Meindok H., Dvorsky R. Serum folate and vitamin-B12 levels in the elderly. J Am Geriatr Soc. 1970 Apr;18(4):317–326. doi: 10.1111/j.1532-5415.1970.tb03185.x. [DOI] [PubMed] [Google Scholar]
  9. Qureshi K. N., Hodkinson H. M. Evaluation of a ten-question mental test in the institutionalized elderly. Age Ageing. 1974 Aug;3(3):152–157. doi: 10.1093/ageing/3.3.152. [DOI] [PubMed] [Google Scholar]
  10. Raper C. G., Choudhury M. Early detection of folic acid deficiency in elderly patients. J Clin Pathol. 1978 Jan;31(1):44–46. doi: 10.1136/jcp.31.1.44. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Read A. E., Gough K. R., Pardoe J. L., Nicholas A. Nutritional studies on the entrants to an old people's home, with particular reference to folic-acid deficiency. Br Med J. 1965 Oct 9;2(5466):843–848. doi: 10.1136/bmj.2.5466.843. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Wickramasinghe S. N., Akinyanju O. O., Grange A., Litwinczuk R. A. Folate levels and deoxyuridine suppression tests in protein-energy malnutrition. Br J Haematol. 1983 Jan;53(1):135–143. doi: 10.1111/j.1365-2141.1983.tb01995.x. [DOI] [PubMed] [Google Scholar]
  13. Wickramasinghe S. N., Litwinczuk R. A., Akinyanju O. O., Grange A. Observations on the mechanisms underlying the defective methylation of deoxyuridylate in kwashiorkor. Br J Haematol. 1983 Oct;55(2):385–387. doi: 10.1111/j.1365-2141.1983.tb01263.x. [DOI] [PubMed] [Google Scholar]
  14. Wickramasinghe S. N. The deoxyuridine suppression test: a review of its clinical and research applications. Clin Lab Haematol. 1981;3(1):1–18. doi: 10.1111/j.1365-2257.1981.tb01304.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES