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LTC residents at risk for vitamin B12 deficiency

March 8, 2016
by Nicole Stempak, Senior Editor
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A recent study shows the importance of vitamin B12–and that seniors in long-term care facilities aren't getting enough of it.

Vitamin B12 deficiency affects up to 43 percent of community-living older adults, and seniors in long-term care (LTC) may be at greater risk, according to findings published in "Applied Physiology, Nutrition and Metabolism." The study looked at 412 residents from eight LTC facilities within one organization in Ontario, Canada, that conducted B12 testing at admission and all residents annually.

Researchers from the University of Waterloo and the Schlegel-University of Waterloo Research Institute for Aging found that 13.8 percent of perspective residents were B12 deficient. A year later, deficiency fell to 7 percent and new cases were reported in 4.2 percent of sampled residents. 

"The negative effects of a B12 deficiency for an at-risk community such as elderly adults in long-term care should be a vital concern for policy makers, staff and leadership at long-term care homes, as well as provincial and federal health departments, and warrants consideration of mandatory B12 screening at admission," says study author Heather Keller, PhD, in a journal press release. "This is of particular importance in the context of our aging population with more Canadians requiring long-term care."

Older adults are more susceptible to B12 deficiency because vitamin absorption ability decreases because of age and medications.

Vitamin B12 is required for proper red blood cell formation, neurological function and DNA synthesis, according to the National Institutes of Health. Vitamin B12 deficiency can cause dementia, confusion, poor memory, megaloblastic anemia, fatigue, weakness, constipation, loss of appetite, weight loss, depression, difficulty maintaining balance and soreness of the mouth and tongue. The deficiency is treatable with injections or high doses of oral vitamin B12.

Canadian seniors are not currently systematically screened at admission to long-term care and sometimes only screened if they show signs of anemia.

"This concept of at admission to LTC is particularly noteworthy in this population as persons receiving transitional care are generally more vulnerable because of the stress and anxiety of relocation; the potential for breakdown in communication on medication and other treatments that are not Incorporated into the resident's care plan post-admission; and change in primary care physician care for the resident," the authors write. "As a result, B12 treatment started in the community (especially intramuscular modality, which is normally provided on a monthly basis, typically in a doctor's office), may be overlooked and lost as a component of the resident's care plan."

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