Review: Cobalamin Deficiency and Mental Impairment in Elderly People

摘要

The prevalence of cobalamin deficiency in elderly people increases with age, and may become a major problem because of the ageing of the population. Diagnosing cobalamin deficiency with primarily neuro-psychiatric manifestations can be difficult in the elderly population, mainly because of the great variety of the symptoms and signs. In addition, haematological abnormalities may be absent. Moreover, the measurement of serum cobalamin levels is not a sensitive method to diagnose cobalamin deficiency. The advent of new and more sensitive techniques makes it possible to diagnose atypical cobalamin deficiency, which was previously often unrecognized, in an early stage of the disease. Studies of serum levels of MMA and homocysteine in relation to clinical symptoms and the effect of cobalamin therapy may expand our knowledge of the prevalence of cobalamin deficiency, the associated clinical syndromes, and the therapeutic options. This is important, because cobalamin deficiency may have to be acknowledged as a significant cause of neuropsy-chiatric disorders in elderly people. Early treatment may prevent irreversibility of the neuropsychological features and organic lesions of the brain related to the deficiency.