The oldest old: Red blood cell and plasma folate in African American and white octogenarians and centenarians in Georgia
- First Online:
- 80 Downloads
To determine the overall folate status of a population-based multi-ethnic sample of octogenarians and centenarians and the specific dietary, demographic and physiological factors associated with observed abnormalities.
Population-based multiethnic sample of adults aged 80 to 89 and 98 and above.
Northern Georgia, USA.
Men and women aged 80 to 89 (octogenarians, n = 77) and 98 and older (centenarians, n = 199).
Wilcoxon rank sum tests, and Chi square and logistic regression analyses were used to examine associations of low and high folate status with hematological indicators and other variables of interest.
The prevalence of low red blood cell (RBC) folate was low overall, but tended to be higher in centenarians than in octogenarians (6.5% vs. 1.3%, p = 0.058; defined as RBC folate < 317 nmol/L). The risk of having lower RBC folate (< 25th vs. > 25th percentile for RBC folate for 60yr+ in NHANES 1999–2000) was greater in association with vitamin B12 deficiency (OR = 5.36; 95%CI: 2.87–10.01), African American race (OR = 4.29; 95%CI: 2.08–8.83), and residence in a skilled nursing facility (OR = 3.25; 95%CI: 1.56–6.78) but was not influenced by age, gender, B-vitamin supplement use, high/low food score or presence of atrophic gastritis. Combined high plasma folate and low vitamin B12 status was present in some individuals (n=11), but was not associated with increased prevalence of anemia or cognitive impairment in this study.
Low RBC folate status (< 317 nmol/L) was rare in this post folic acid fortification sample of octogenarians and centenarians. RBC folate status (< 25th percentile) was strongly associated with 1) vitamin B12 deficiency, which has strong implications for vitamin treatment, and 2) with being African American, suggesting racial disparities exist even in the oldest old.
Key wordsFolate vitamin B12 centenarians disparities fortification
Unable to display preview. Download preview PDF.
- 14.McDowell MA, Lacher DA, Pfeiffer CM, Mulinare J, Picciano MF, Rader JI, Yetley EA, Kennedy-Stephenson, J, Johnson CL. Blood folate levels: the latest NHANES results. NCHS Date Brief 2008; May:1–8.Google Scholar
- 21.Miller JW, Garrod MG, Allen LH, Haan MN, Green R. Metabolic evidence of vitamin B-12 deficiency, including high homocysteine and methlymalonic acid and low holotranscobalamin, is more pronounced in older adults with elevated plasma folate. Am J Clin Nutr 2009;90:1586–1592.PubMedCrossRefGoogle Scholar
- 22.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
- 29.Blanc B, Finch CA, Hallberg L, et al. Nutritional anaemias. Report of a WHO Scientific Group. WHO Tech Rep Ser. 1968;405:1–40.Google Scholar
- 32.US Department of Health and Human Services and US Department of Agriculture (2005) Dietary Guidelines for Americans 2005. Available online at http://www.health.gov/dietaryguidelines/dga2005/document/pdf/DGA2005.pdf
- 33.National Institutes of Health: National Heart Lung and Blood Institute, North American Association for the Study of Obesity. Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. 2000 [cited; 1–80]. Available from: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf
- 35.Folstein MF, Folstein SE, McHugh PR, Fanjiang G. Mini-Mental State Examination user’s guide. Odessa, FL: Psychological Assessment Resources 2001.Google Scholar
- 38.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
- 40.Stabler SP. Vitamin B12. In: Present Knowledge in Nutrition, 9th edition, Volume II. Bowan BA, Russell RM, eds. International Life Sciences Institute, Washington, DC 2006.Google Scholar