[ study of folate and cobalamin deficiency in elderly by determining a cut-off point with laboratory markers]

ABSTRACT

Prevalence of folate and cobalamin deficiency in elderly is high. Determining a cut off point for low and marginal levels of folate and cobalamin deficiency before development of anemia or neurocognitive presentations in elderly is essential. In this cross-sectional study 280 persons above 65 years old in the twelve regions of Mashhad city were admitted to Emam Reza [pbuh] hospital. They were physically examined by a general practitioner. Other data were obtained by questionnaire. Serum cobalamin and folate level were analyzed by RIA method. 76 persons, who had cobalamin of 120-450 pg/ml and folate of 1.5-7 ng/ml without any interfering factor for homocystein [Hey] measurement [creatinin> 1.5 g/dl, cigarette smoking and consuming certain kind of drugs] were analyzed for serum homocystein by Elisa method. All collected data was statistically analyzed by SPSS software. 48.7% of elderly had hyperhomocysteinemia. Hey was inversely correlated with cobalamin [p=0.001] and folate below cut off point [p=0.044]. For Hcy>15 mol/micro, cut off points for cobalamin and folate deficiency were <330 pg/ml and <6.5 ng/ml respectively. Prevalence of cobalamin deficiency in low levels [<122 pg/ml] was 22.7% and in marginal levels [122-330 pg/ml] was 51.8%. Prevalence of folate deficiency in low levels [<3 ng/ml] was 16.7% and in marginal levels [<6.5 ng/ml] was 64.2%. According to definition of cut off point, Prevalence of cobalamin and folate deficiency especially in marginal levels was higher than which is recorded. It is recommended that before development of signs and symptoms and other complications of hyperhomocysteinemia, all elderly patients undergoes screening for cobalamin and folate deficiency in appropriate intervals