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Folate deficiency, high homocysteine levels associated with anemia in elderly cohort

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Vitamin B₁₂ deficiency was not related to the development of anemia in elderly people aged 85 years, according to data from the Leiden 85-Plus Study.

According to researchers from Leiden University Medical Center in the Netherlands, folate deficiency and elevated homocysteine levels played a role in anemia development in people aged 85 years and older.

The population-based, prospective study included data for 423 elderly participants aged 85 years. At baseline, the researchers obtained B₁₂, folate and homocysteine levels. Each year for five years of follow-up the researchers examined hemoglobin levels and mean corpuscular volume.

At baseline, anemia was associated with folate levels <7 nmol/L (n=34; OR=2.44; 95% CI, 1.06-5.61) and levels of homocysteine >13.5 mcmol/L (n=194; OR=1.82; 95% CI, 1.08-3.06). However, vitamin B₁₂ levels <150 pmol/L were not associated with anemia (n=68; OR=1.51; 95% CI, 0.79-2.87).

Vitamin B₁₂ deficiency was not associated with the development of anemia (HR=0.92; 95% CI, 0.46-1.82) or changes in mean corpuscular volume (P=.77), according to the researchers.

From age 85 years and older, folate deficiency (HR=3.33; 95% CI, 1.55-7.14) and higher homocysteine levels (HR=1.70; 95% CI, 1.01-2.88) were associated with anemia development. However, they were not associated with an increase in mean corpuscular volume (P>.30).

“Although the biochemical pathways suggest that folic acid supplementation is beneficial, it remains to be seen if folic acid fortification of grain and cereal products has a positive effect on the incidence of anemia in the very elderly population,” the researchers wrote.

Arch Intern Med. 2008;168:2238-2244.