Research Article
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Evaluation of Vitamin B12 deficiency Anemia in Geriatric Patients

Year 2024, Volume: 10 Issue: 4, 322 - 330, 30.11.2024
https://doi.org/10.19127/mbsjohs.1488963

Abstract

Objective: In our study, we aimed to evaluate vitamin B12 deficiency anemia, macrocytosis rate and vitamin B12 values in patients over 65 years of age and compare them with those under 65 years of age groups.
Method: Retrospectively, A total of 8062 patients, 1213 over the age of 65 and 6849 under the age of 65, admitted between March 2019 and March 2024 were included in the study. The patients' hemoglobin, hematocrit, Mean corpuscular volume (MCV), White blood cell (WBC), Red cell distribution width (RDW), Platelet (PLT) values and vitamin B12 levels were examined. Patients were divided into two groups as age of 65 and over ( geriatrics) and age below 65 (young-adults), and each group were divided into two groups in terms of anemia. Groups and subgropus were compared with each other.
Results: While the ratio of vitamin B12 deficiency anemia in geriatrics was 20.2%, in young-adults it was 8.3%. No difference was observed in vitamin B12 levels in terms of gender in both age groups significantly. With the roc analyses the cut-off value for vitamin B12 causing anemia in elderly patients was 327 pg/mL (AUC: 0.602, p≤0.001) with a sensitivity of 94.3% and specificity of 34.2%.
Conclusion: The fact that vitamin B12 levels that cause anemia in elderly patients are higher than in young-adult patients made us think that the usual limit values may need to be reconsiderated in geriatric population

Project Number

2024/5381

References

  • Mulherin BP, Yeh M, Al-Adhami M, Dingli D. Normalization of Hemoglobin, Lactate Dehydrogenase, and Fatigue in Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with Pegcetacoplan. Drugs R D. 2024;24(2):169-177
  • Mulherin BP, Yeh M, Al-Adhami M, Dingli D. Normalization of Hemoglobin, Lactate Dehydrogenase, and Fatigue in Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with Pegcetacoplan. Drugs R D. 2024;24(2):169-177
  • Ertilav M. What is the Target Hemoglobin Level Under the Scope of Current Issues? Turkish Clinics J Nephrol-Special Topics. 2012;5(2):57-62
  • Ertilav M. What is the Target Hemoglobin Level Under the Scope of Current Issues? Turkish Clinics J Nephrol-Special Topics. 2012;5(2):57-62
  • Institute of Medicine (US) Committee to Design a Strategy for Quality Review and Assurance in Medicare; Lohr KN, editor. Medicare: A Strategy for Quality Assurance: Volume 1. Washington (DC): National Academies Press (US); 1990. 3, The Elderly Population
  • Institute of Medicine (US) Committee to Design a Strategy for Quality Review and Assurance in Medicare; Lohr KN, editor. Medicare: A Strategy for Quality Assurance: Volume 1. Washington (DC): National Academies Press (US); 1990. 3, The Elderly Population
  • Edwards N, Baird C. Interpreting laboratory values in older adults. Medsurg Nurs. 2005;14(4):220-9; quiz 230. PMID: 16206892.
  • Edwards N, Baird C. Interpreting laboratory values in older adults. Medsurg Nurs. 2005;14(4):220-9; quiz 230. PMID: 16206892.
  • Coskun A, Sandberg S, Unsal I, Serteser M, Aarsand AK. Personalized reference intervals: from theory to practice. Crit Rev Clin Lab Sci. 2022;59(7):501-516.
  • Coskun A, Sandberg S, Unsal I, Serteser M, Aarsand AK. Personalized reference intervals: from theory to practice. Crit Rev Clin Lab Sci. 2022;59(7):501-516.
  • Fischbach, F.T., Fischbach M., Stout K. (2021). A manual of laboratory and diagnostic tests (11th ed.). Philadelphia: Lippincott
  • Fischbach, F.T., Fischbach M., Stout K. (2021). A manual of laboratory and diagnostic tests (11th ed.). Philadelphia: Lippincott
  • Elkıran T, Çelebi H. Determination of Laboratory and Clinical Findings in Patients with Megaloblastic Aanemia. Fırat Medical Journal 2001;6: 534-9.
  • Elkıran T, Çelebi H. Determination of Laboratory and Clinical Findings in Patients with Megaloblastic Aanemia. Fırat Medical Journal 2001;6: 534-9.
  • Kara İH, Kandiş H, Bahçebaşı T, Köylü OK, Sayın S, Demirin H et al. Evaluation of Elderly Patients at Check-Up Polyclinics for Anemia, Serum Folate and Cobalamin Levels. Turkish Journal of Biochemistry–Turk J Biochem 2010; 35 (4): 350–355.
  • Kara İH, Kandiş H, Bahçebaşı T, Köylü OK, Sayın S, Demirin H et al. Evaluation of Elderly Patients at Check-Up Polyclinics for Anemia, Serum Folate and Cobalamin Levels. Turkish Journal of Biochemistry–Turk J Biochem 2010; 35 (4): 350–355.
  • Klee GG. Cobalamin and folate evaluation: measurements of methylmalonic acid and homocystein vs vitamin B12 and folate. Clin Chem 2000;46:1277-83.
  • Klee GG. Cobalamin and folate evaluation: measurements of methylmalonic acid and homocystein vs vitamin B12 and folate. Clin Chem 2000;46:1277-83.
  • Andrès E, Perrin AE, Kraemer JP, Goichot B, Demangeat C, Ruellan A, et al. Anémies par carence en vitamine B12 chez le sujet âgé de plus de 75 ans: nouveaux concepts. À propos de 20 observations. Rev Med Interne 2000;21:946-55
  • Andrès E, Perrin AE, Kraemer JP, Goichot B, Demangeat C, Ruellan A, et al. Anémies par carence en vitamine B12 chez le sujet âgé de plus de 75 ans: nouveaux concepts. À propos de 20 observations. Rev Med Interne 2000;21:946-55
  • Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view. World J Gastroenterol 2009; 15: 5121–8.
  • Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view. World J Gastroenterol 2009; 15: 5121–8.
  • Oh RC, Brown DL. Vitamin B12 deficiency. Am Fam Physician 2003; 67: 979–86.
  • Oh RC, Brown DL. Vitamin B12 deficiency. Am Fam Physician 2003; 67: 979–86.
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ. 1997 8;314(7078):430-3.
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ. 1997 8;314(7078):430-3.
  • Sun A, Chang JY, Wang YP, Cheng SJ, Chen HM, Chiang CP. Do all the patients with vitamin B12 deficiency have pernicious anemia? J Oral Pathol Med. 2016;45(1):23-7.
  • Sun A, Chang JY, Wang YP, Cheng SJ, Chen HM, Chiang CP. Do all the patients with vitamin B12 deficiency have pernicious anemia? J Oral Pathol Med. 2016;45(1):23-7.
  • Bone marrow, thymus and blood: changes across the lıfespan. Aging Health. 2009;5(3):385-393.
  • Bone marrow, thymus and blood: changes across the lıfespan. Aging Health. 2009;5(3):385-393.
  • Andrès E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ. 2004;171(3):251-9.
  • Andrès E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ. 2004;171(3):251-9.
  • Stopeck A. Links between Helicobacter pylori in - fection, cobalamin deficiency, and pernicious anemia. Arch In - tern Med. 2000;160: 1229-30.
  • Stopeck A. Links between Helicobacter pylori in - fection, cobalamin deficiency, and pernicious anemia. Arch In - tern Med. 2000;160: 1229-30.
  • Akbarpour E, Paridar Y, Mohammadi Z, Mard A, Danehchin L, Abolnezhadian F, et al. Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: the Khuzestan Comprehensive Health Study (KCHS). BMC Public Health. 2022;22(1):168.
  • Akbarpour E, Paridar Y, Mohammadi Z, Mard A, Danehchin L, Abolnezhadian F, et al. Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: the Khuzestan Comprehensive Health Study (KCHS). BMC Public Health. 2022;22(1):168.
  • Özgümüş T. Anemia in the geriatric age group. Safer U, editor. Approach to Common Internal Problems in the Elderly. 1st Edition. Ankara: Turkish Clinics; 2021:.48-53.
  • Özgümüş T. Anemia in the geriatric age group. Safer U, editor. Approach to Common Internal Problems in the Elderly. 1st Edition. Ankara: Turkish Clinics; 2021:.48-53.
  • Maner BS, Killeen RB, Moosavi L. Mean Corpuscular Volume. 2024 Mar 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31424859.
  • Maner BS, Killeen RB, Moosavi L. Mean Corpuscular Volume. 2024 Mar 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31424859.
  • Lee JY, Choi H, Park JW, Son BR, Park JH, Jang LC, et al. Age-related changes in mean corpuscular volumes in patients without anaemia: An analysis of large-volume data from a single institute. J Cell Mol Med. 2022;26(12):3548-3556. doi: 10.1111/jcmm.17397. Epub 2022 May 22.
  • Lee JY, Choi H, Park JW, Son BR, Park JH, Jang LC, et al. Age-related changes in mean corpuscular volumes in patients without anaemia: An analysis of large-volume data from a single institute. J Cell Mol Med. 2022;26(12):3548-3556. doi: 10.1111/jcmm.17397. Epub 2022 May 22.
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ 1997;314:430-433
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ 1997;314:430-433
  • Ozkur M, Benlier N, Yilmaz M. Drug-Induced Macrocytosis. Yilmaz M, editor. Macrocytic Anemias. 1st Edition. Ankara: Turkish Clinics; 2019:.27-33.
  • Ozkur M, Benlier N, Yilmaz M. Drug-Induced Macrocytosis. Yilmaz M, editor. Macrocytic Anemias. 1st Edition. Ankara: Turkish Clinics; 2019:.27-33.
  • Nagao T, Hirokawa M. Diagnosis and treatment of macrocytic anemias in adults. J Gen Fam Med. 2017;18(5):200-204.
  • Nagao T, Hirokawa M. Diagnosis and treatment of macrocytic anemias in adults. J Gen Fam Med. 2017;18(5):200-204.
  • World Health Organization. Nutritional anemias. Report on a Scientific Group. World Health Organ Tech Rep Ser. 1968;s: 405.
  • World Health Organization. Nutritional anemias. Report on a Scientific Group. World Health Organ Tech Rep Ser. 1968;s: 405.
  • Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER. et al. Neu - ropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988:318:1720–8
  • Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER. et al. Neu - ropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988:318:1720–8
Year 2024, Volume: 10 Issue: 4, 322 - 330, 30.11.2024
https://doi.org/10.19127/mbsjohs.1488963

Abstract

Project Number

2024/5381

References

  • Mulherin BP, Yeh M, Al-Adhami M, Dingli D. Normalization of Hemoglobin, Lactate Dehydrogenase, and Fatigue in Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with Pegcetacoplan. Drugs R D. 2024;24(2):169-177
  • Mulherin BP, Yeh M, Al-Adhami M, Dingli D. Normalization of Hemoglobin, Lactate Dehydrogenase, and Fatigue in Patients with Paroxysmal Nocturnal Hemoglobinuria Treated with Pegcetacoplan. Drugs R D. 2024;24(2):169-177
  • Ertilav M. What is the Target Hemoglobin Level Under the Scope of Current Issues? Turkish Clinics J Nephrol-Special Topics. 2012;5(2):57-62
  • Ertilav M. What is the Target Hemoglobin Level Under the Scope of Current Issues? Turkish Clinics J Nephrol-Special Topics. 2012;5(2):57-62
  • Institute of Medicine (US) Committee to Design a Strategy for Quality Review and Assurance in Medicare; Lohr KN, editor. Medicare: A Strategy for Quality Assurance: Volume 1. Washington (DC): National Academies Press (US); 1990. 3, The Elderly Population
  • Institute of Medicine (US) Committee to Design a Strategy for Quality Review and Assurance in Medicare; Lohr KN, editor. Medicare: A Strategy for Quality Assurance: Volume 1. Washington (DC): National Academies Press (US); 1990. 3, The Elderly Population
  • Edwards N, Baird C. Interpreting laboratory values in older adults. Medsurg Nurs. 2005;14(4):220-9; quiz 230. PMID: 16206892.
  • Edwards N, Baird C. Interpreting laboratory values in older adults. Medsurg Nurs. 2005;14(4):220-9; quiz 230. PMID: 16206892.
  • Coskun A, Sandberg S, Unsal I, Serteser M, Aarsand AK. Personalized reference intervals: from theory to practice. Crit Rev Clin Lab Sci. 2022;59(7):501-516.
  • Coskun A, Sandberg S, Unsal I, Serteser M, Aarsand AK. Personalized reference intervals: from theory to practice. Crit Rev Clin Lab Sci. 2022;59(7):501-516.
  • Fischbach, F.T., Fischbach M., Stout K. (2021). A manual of laboratory and diagnostic tests (11th ed.). Philadelphia: Lippincott
  • Fischbach, F.T., Fischbach M., Stout K. (2021). A manual of laboratory and diagnostic tests (11th ed.). Philadelphia: Lippincott
  • Elkıran T, Çelebi H. Determination of Laboratory and Clinical Findings in Patients with Megaloblastic Aanemia. Fırat Medical Journal 2001;6: 534-9.
  • Elkıran T, Çelebi H. Determination of Laboratory and Clinical Findings in Patients with Megaloblastic Aanemia. Fırat Medical Journal 2001;6: 534-9.
  • Kara İH, Kandiş H, Bahçebaşı T, Köylü OK, Sayın S, Demirin H et al. Evaluation of Elderly Patients at Check-Up Polyclinics for Anemia, Serum Folate and Cobalamin Levels. Turkish Journal of Biochemistry–Turk J Biochem 2010; 35 (4): 350–355.
  • Kara İH, Kandiş H, Bahçebaşı T, Köylü OK, Sayın S, Demirin H et al. Evaluation of Elderly Patients at Check-Up Polyclinics for Anemia, Serum Folate and Cobalamin Levels. Turkish Journal of Biochemistry–Turk J Biochem 2010; 35 (4): 350–355.
  • Klee GG. Cobalamin and folate evaluation: measurements of methylmalonic acid and homocystein vs vitamin B12 and folate. Clin Chem 2000;46:1277-83.
  • Klee GG. Cobalamin and folate evaluation: measurements of methylmalonic acid and homocystein vs vitamin B12 and folate. Clin Chem 2000;46:1277-83.
  • Andrès E, Perrin AE, Kraemer JP, Goichot B, Demangeat C, Ruellan A, et al. Anémies par carence en vitamine B12 chez le sujet âgé de plus de 75 ans: nouveaux concepts. À propos de 20 observations. Rev Med Interne 2000;21:946-55
  • Andrès E, Perrin AE, Kraemer JP, Goichot B, Demangeat C, Ruellan A, et al. Anémies par carence en vitamine B12 chez le sujet âgé de plus de 75 ans: nouveaux concepts. À propos de 20 observations. Rev Med Interne 2000;21:946-55
  • Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view. World J Gastroenterol 2009; 15: 5121–8.
  • Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view. World J Gastroenterol 2009; 15: 5121–8.
  • Oh RC, Brown DL. Vitamin B12 deficiency. Am Fam Physician 2003; 67: 979–86.
  • Oh RC, Brown DL. Vitamin B12 deficiency. Am Fam Physician 2003; 67: 979–86.
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ. 1997 8;314(7078):430-3.
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ. 1997 8;314(7078):430-3.
  • Sun A, Chang JY, Wang YP, Cheng SJ, Chen HM, Chiang CP. Do all the patients with vitamin B12 deficiency have pernicious anemia? J Oral Pathol Med. 2016;45(1):23-7.
  • Sun A, Chang JY, Wang YP, Cheng SJ, Chen HM, Chiang CP. Do all the patients with vitamin B12 deficiency have pernicious anemia? J Oral Pathol Med. 2016;45(1):23-7.
  • Bone marrow, thymus and blood: changes across the lıfespan. Aging Health. 2009;5(3):385-393.
  • Bone marrow, thymus and blood: changes across the lıfespan. Aging Health. 2009;5(3):385-393.
  • Andrès E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ. 2004;171(3):251-9.
  • Andrès E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ. 2004;171(3):251-9.
  • Stopeck A. Links between Helicobacter pylori in - fection, cobalamin deficiency, and pernicious anemia. Arch In - tern Med. 2000;160: 1229-30.
  • Stopeck A. Links between Helicobacter pylori in - fection, cobalamin deficiency, and pernicious anemia. Arch In - tern Med. 2000;160: 1229-30.
  • Akbarpour E, Paridar Y, Mohammadi Z, Mard A, Danehchin L, Abolnezhadian F, et al. Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: the Khuzestan Comprehensive Health Study (KCHS). BMC Public Health. 2022;22(1):168.
  • Akbarpour E, Paridar Y, Mohammadi Z, Mard A, Danehchin L, Abolnezhadian F, et al. Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: the Khuzestan Comprehensive Health Study (KCHS). BMC Public Health. 2022;22(1):168.
  • Özgümüş T. Anemia in the geriatric age group. Safer U, editor. Approach to Common Internal Problems in the Elderly. 1st Edition. Ankara: Turkish Clinics; 2021:.48-53.
  • Özgümüş T. Anemia in the geriatric age group. Safer U, editor. Approach to Common Internal Problems in the Elderly. 1st Edition. Ankara: Turkish Clinics; 2021:.48-53.
  • Maner BS, Killeen RB, Moosavi L. Mean Corpuscular Volume. 2024 Mar 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31424859.
  • Maner BS, Killeen RB, Moosavi L. Mean Corpuscular Volume. 2024 Mar 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31424859.
  • Lee JY, Choi H, Park JW, Son BR, Park JH, Jang LC, et al. Age-related changes in mean corpuscular volumes in patients without anaemia: An analysis of large-volume data from a single institute. J Cell Mol Med. 2022;26(12):3548-3556. doi: 10.1111/jcmm.17397. Epub 2022 May 22.
  • Lee JY, Choi H, Park JW, Son BR, Park JH, Jang LC, et al. Age-related changes in mean corpuscular volumes in patients without anaemia: An analysis of large-volume data from a single institute. J Cell Mol Med. 2022;26(12):3548-3556. doi: 10.1111/jcmm.17397. Epub 2022 May 22.
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ 1997;314:430-433
  • Hoffbrand V, Provan D. ABC of clinical haematology. Macrocytic anaemias. BMJ 1997;314:430-433
  • Ozkur M, Benlier N, Yilmaz M. Drug-Induced Macrocytosis. Yilmaz M, editor. Macrocytic Anemias. 1st Edition. Ankara: Turkish Clinics; 2019:.27-33.
  • Ozkur M, Benlier N, Yilmaz M. Drug-Induced Macrocytosis. Yilmaz M, editor. Macrocytic Anemias. 1st Edition. Ankara: Turkish Clinics; 2019:.27-33.
  • Nagao T, Hirokawa M. Diagnosis and treatment of macrocytic anemias in adults. J Gen Fam Med. 2017;18(5):200-204.
  • Nagao T, Hirokawa M. Diagnosis and treatment of macrocytic anemias in adults. J Gen Fam Med. 2017;18(5):200-204.
  • World Health Organization. Nutritional anemias. Report on a Scientific Group. World Health Organ Tech Rep Ser. 1968;s: 405.
  • World Health Organization. Nutritional anemias. Report on a Scientific Group. World Health Organ Tech Rep Ser. 1968;s: 405.
  • Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER. et al. Neu - ropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988:318:1720–8
  • Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER. et al. Neu - ropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988:318:1720–8
There are 52 citations in total.

Details

Primary Language English
Subjects Geriatrics and Gerontology
Journal Section Research articles
Authors

Aslıhan Mete Yıldırım 0000-0001-7482-4596

Funda Datlı Yakaryılmaz 0000-0001-5633-0939

Project Number 2024/5381
Publication Date November 30, 2024
Submission Date May 24, 2024
Acceptance Date October 25, 2024
Published in Issue Year 2024 Volume: 10 Issue: 4

Cite

Vancouver Mete Yıldırım A, Datlı Yakaryılmaz F. Evaluation of Vitamin B12 deficiency Anemia in Geriatric Patients. Mid Blac Sea J Health Sci. 2024;10(4):322-30.

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