Skip to main content
SpringerLink
Log in

Vitamin B12 deficiency in African American and white octogenarians and centenarians in Georgia

The journal of nutrition, health & aging volume 14, pages 339–345 (2010)Cite this article

Abstract

Objective

Test the hypotheses that vitamin B12 deficiency would be prevalent in octogenarians and centenarians and associated with age, gender, race/ethnicity, living arrangements (community or skilled nursing facility), animal food intake, B-vitamin supplement use, atrophic gastritis, folate status, and hematological indicators.

Design

Population-based multi-ethnic sample of adults aged 80 to 89 and 98 and above.

Setting

Northern Georgia in the United States.

Participants

Men and women aged 80 to 89 (octogenarians, n = 80) and 98 and older (centenarians, n = 231).

Measurements

Wilcoxon signed-rank tests, Fisher℉s exact tests, and logistic regression analysis was used to examine the associations of vitamin B12 status with the variables of interest.

Results

After excluding participants receiving vitamin B12 injections (n = 17), the prevalence of vitamin B12 deficiency was higher in centenarians than in octogenarians (35.3% vs. 22.8%, p < 0.05, defined as plasma vitamin B12 < 258 pmol/L and serum methylmalonic acid > 271 nmol/L and methylmalonic acid > serum 2-methylcitrate) and in both age groups was correlated with significantly higher homocysteine (p < 0.05) and lower plasma and red cell folate (p < 0.01), but was not related to hemoglobin, anemia, mean cell volume, or macrocytosis. In logistic regression analysis, the probability of being vitamin B12-deficient was significantly increased by being a centenarian vs. octogenarian (p < 0.03), by being white vs. African American (p < 0.02), by increasing severity of atrophic gastritis (p < 0.001), and by not taking oral B-vitamin supplements (p < 0.01), but was not related to gender, living arrangements, or animal food intake.

Conclusions

Centenarians and octogenarians are at high risk for vitamin B12 deficiency for many of the same reasons identified in other older adult populations. Given the numerous potential adverse consequences of poor vitamin B12 status, efforts are needed to ensure vitamin B12 adequacy in these older adults.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Poon LW, Jazwinski SM, Green RC, Woodard JL, Martin P, Rodgers WL, Johnson MA, Hausman DB, Arnold J, et al. Methodological considerations in studying centenarians: lessons learned from the Georgia centenarian studies. Ann Rev Gerontology and Geriatrics 2007;27:213–264.

    Google Scholar 

  2. Johnson MA, Davey A, Park S, Hausman DB, Poon LW, For the Georgia Centenarian Study, Age, race and eason predict vitamin D status in African American and White octogenarians and centenarians. J Nutr Health Aging 2008;12(10):690–695.

    CAS  PubMed  Google Scholar 

  3. Chan YC, Suzuki M, Yamamoto S. Dietary, anthropometric, hematological and biochemical assessment of the nutritional status of centenarians and elderly people in Okinawa, Japan. J Am Coll Nutr 1997;16(3):229–235.

    CAS  PubMed  Google Scholar 

  4. Basile G, Gangemi S, Lo Balbo C, Mento A, Nicita-Mauro C, Crisafulli G, Merendino RA, Ientile R, Nicita-Mauro V. Correlation between serum retinol and alpha-tocopherol levels in centenarians. J Nutr Sci Vitaminol (Tokyo) 2003;49:287–288.

    CAS  Google Scholar 

  5. Pinzani P, Petruzzi E, Orlando C, Poggesi M, Monami M, Pazzagli M, Masotti G. Serum total antioxidant capacity, DHEAS and IGF-I in healthy centenarian subjects. J Endocrinol Invest 2002;25(10 Suppl):83–84.

    CAS  PubMed  Google Scholar 

  6. Mecocci P, Polidori MC, Troiano L, Cherubini A, Cecchetti R, Pini G, Straatman M, Monti D, Stahl W, et al. Plasma antioxidants and longevity: a study on healthy centenarians. Free Radic Biol Med 2000;28(8):1243–1248. Erratum in: Free Radic Biol Med 2000;29:486.

    Article  CAS  PubMed  Google Scholar 

  7. Arakawa M, Miyake Y, Taira K. Hypertension and stroke in centenarians, Okinawa, Japan. Cerebrovascular Diseases 2005;20(4):233–238.

    Article  PubMed  Google Scholar 

  8. Atzmon G, Schechter C, Greiner W, Davidson D, Rennert G, Barzilai N. Clinical phenotype of families with longevity. J Am Geriatr Soc 2000;52(2):274–277.

    Article  Google Scholar 

  9. Evert J, Lawler E, Bogan H. Perls T. Morbidity profiles of centenarians: survivors, delayers, and escapers. J Gerontol A Biol Sci Med Sci 2003;58(3):232–237.

    PubMed  Google Scholar 

  10. Terry DF, Wilcox MA, McCormick, MA, Pennington JY, Schoenhofen EA, Andersen SL, Perls TT. Lower all-cause, cardiovascular, and cancer mortality in centenarians’ offspring. J Am Geriatr Soc 2004;52(12);2074–2076.

    Article  PubMed  Google Scholar 

  11. Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M, et al. Low vitamin D status, high bone turnover, and bone fractures in centenarians. J Clin Endocrinol Metab 2003;88(11):5109–5115.

    Article  CAS  PubMed  Google Scholar 

  12. Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Food and Nutrition Board. National Academy of Sciences. 1998. Washington DC: National Academy Press.

    Google Scholar 

  13. Baik HW, Russell RM. Vitamin B12 deficiency in the elderly. Annu Rev Nutr 1999;19:357–377.

    Article  CAS  PubMed  Google Scholar 

  14. Wolters M, Ströhle A, Hahn A. Cobalamin: a critical vitamin in the elderly. Prev Med 2004;39(6):1256–1266.

    Article  CAS  PubMed  Google Scholar 

  15. Ryan-Harshman M, Aldoori W. Vitamin B12 and health. Can Fam Physician 2008;54(4):536–541.

    PubMed  Google Scholar 

  16. Matteini AM, Walston JD, Fallin MD, Bandeen-Roche K, Kao WH, Semba RD, Allen RH, Guralnik J, Fried LP, Stabler SP. Markers of B-vitamin deficiency and frailty in older women. J Nutr Health Aging 2008;12(5):303–308.

    Article  CAS  PubMed  Google Scholar 

  17. Penninx BW, Guralnik JM, Ferrucci L, Fried LP, Allen RH, Stabler SP. Vitamin B(12) deficiency and depression in physically disabled older women: epidemiologic evidence from the Women’s Health and Aging Study. Am J Psychiatry 2000;157(5):715–721.

    Article  CAS  PubMed  Google Scholar 

  18. Stabler SP, Allen RH, Fried LP, Pahor M, Kittner SJ, Penninx BW, Guralnik JM. Racial differences in prevalence of cobalamin and folate deficiencies in disabled elderly women. Am J Clin Nutr 1999;70(5):911–919.

    CAS  PubMed  Google Scholar 

  19. Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER, Marcell PD, Stabler SP, Allen RH. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med 1988;318(26):1720–1728.

    CAS  PubMed  Google Scholar 

  20. Stabler SP, Allen RH, Savage DG, Lindenbaum J. Clinical spectrum and diagnosis of cobalamin deficiency. Blood 1990;76(5):871–881.

    CAS  PubMed  Google Scholar 

  21. Carmel R. Ethnic and racial factors in cobalamin metabolism and its disorders. Semin Hematol 1999;36(1):88–100.

    CAS  PubMed  Google Scholar 

  22. Carmel R. Anemia and aging: an overview of clinical, diagnostic and biological issues. Blood Rev 2001;15(1):9–18.

    Article  CAS  PubMed  Google Scholar 

  23. Johnson MA, Hawthorne NA, Brackett WR, Fischer JG, Gunter EW, Allen RH, Stabler SP. Hyperhomocysteinemia and vitamin B-12 deficiency in elderly using Title IIIc nutrition services. Am J Clin Nutr 2003;77(1):211–220.

    CAS  PubMed  Google Scholar 

  24. Park S, Johnson MA, Shea-Miller K, De Chicchis AR, Allen RH, Stabler SP. Agerelated hearing loss, methylmalonic acid, and vitamin B12 status in older adults. J Nutr Elder 2006;25(3–4):105–120.

    PubMed  Google Scholar 

  25. Lewis MS, Miller LS, Johnson MA, Dolce EB, Allen RH, Stabler SP. Elevated methylmalonic acid is related to cognitive impairment in older adults enrolled in an elderly nutrition program. J Nutr Elder 2005;24(3):47–65.

    Article  PubMed  Google Scholar 

  26. Loikas S, Koskinen P, Irjala K, Löppönen M, Isoaho R, Kivelä SL, Pelliniemi TT. Vitamin B12 deficiency in the aged: a population-based study. Age Ageing 2007;36(2):177–183.

    Article  PubMed  Google Scholar 

  27. Samloff IM, Varis K, Ihamaki T, Siurala M, Rotter JI. Relations among serum pepsinogen I, serum pepsinogen II, and gastric mucosal histology: a study in relatives of patients with pernicious anemia. Gastroenterology 1982;83:204–209.

    CAS  PubMed  Google Scholar 

  28. Stabler SP, Marcell PD, Podell ER, et al. Assay of methylmalonic acid in the serum of patients with cobalamin deficiency using capillary gas chromatography-mass spectrometry. J Clin Invest 1986;77:1610–1612.

    Article  Google Scholar 

  29. Stabler SP, Marcell PD, Podell ER, et al. Elevation of total homocysteine in the serum of patients with cobalamin or folate deficiency detected by capillary gas chromatography-mass spectrometry. J Clin Invest 1988;81:466–474.

    Article  CAS  PubMed  Google Scholar 

  30. Allen RH, Stabler SP, Savage DG, et al. Elevation of 2-methylcitric acid I and II levels in serum, urine, and cerebrospinal fluid of patients with cobalamin deficiency. Metabolism 1993;42:978–988.

    Article  CAS  PubMed  Google Scholar 

  31. World Health Organization. Iron deficiency anaemia — Assessment, prevention, and control. A guide for programme managers. Geneva: World Health Organization, 2001. Internet: http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/en/ida_assessment_prevention_control.pdf (accessed November 1, 2008).

    Google Scholar 

  32. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the Mini-Nutritional Assessment as part of the geriatric evaluation. Nutr Rev; 1996;54:59–65.

    Article  Google Scholar 

  33. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189–198.

    Article  CAS  PubMed  Google Scholar 

  34. Eisenstaedt R, Penninx BW, Woodman RC. Anemia in the elderly: current understanding and emerging concepts. Blood Rev 2006;20(4):213–226.

    Article  PubMed  Google Scholar 

  35. Pfeiffer CM, Johnson CL, Jain RB, Yetley EA, Picciano MF, Rader JI, Fisher KD, Mulinare J, Osterloh JD. Trends in blood folate and vitamin B-12 concentrations in the United States, 1988–2004. Am J Clin Nutr 2007;86(3):718–727.

    CAS  PubMed  Google Scholar 

  36. Morris MS, Jacques PF, Rosenberg IH, Selhub J. Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification. Am J Clin Nutr 2007;85(1):193–200.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Foods and Nutrition, University of Georgia, Athens, GA, USA

    Mary Ann Johnson & D. B. Hausman

  2. College of Health Professions, Temple University, Philadelphia, PA, USA

    A. Davey

  3. Institute of Gerontology, University of Georgia, Athens, GA, USA

    L. W. Poon

  4. University of Colorado Denver Health Sciences Center, Aurora, CO, USA

    R. H. Allen & S. P. Stabler

  5. Department of Foods and Nutrition, The University of Georgia, 280 Dawson Hall, Athens, GA, 30602, USA

    Mary Ann Johnson

Authors
  1. Mary Ann Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. B. Hausman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Davey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. W. Poon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. H. Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. P. Stabler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mary Ann Johnson.

Additional information

FOR THE GEORGIA GENTENARIAN STUDY

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Johnson, M.A., Hausman, D.B., Davey, A. et al. Vitamin B12 deficiency in African American and white octogenarians and centenarians in Georgia. J Nutr Health Aging 14, 339–345 (2010). https://doi.org/10.1007/s12603-010-0077-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-010-0077-y

Keywords

search

Navigation