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.
