Long term health problems related to a Vitamin B12 deficiency

Vitamin B12 deficiency has been associated with the development of age related macular degeneration (AMD) and risk of frailty, both leading causes of disability in the elderly.

AMD is the leading cause of vision loss in the elderly. Risk factors include increasing age, family history, hypertension, smoking, obesity, sunlight exposure and hypercholesterolemia. Some but not all cross sectional studies have found lower vitamin B12 concentrations in AMD cases. However, a recent RCT with 5205 female health professionals at risk of vascular disease found a 34% reduction in the relative risk of AMD after supplementation with vitamins B12, B6 and folate (daily doses of 1 mg, 50 mg, 2.5 mg respectively).

Frailty is characterised by muscle wasting, diminished strength, often with weight loss with or without reduced nutritional intake. Frailty is associated with an increased vulnerability to stresses, causing longer and more complicated recovery from illness or surgery.

Increased risk of frailty and disability has been associated with poor B vitamin status. Subjects with vitamins B12 and B6 in the lowest quintiles and subjects with elevated MMA and tHcy concentrations, have been found to have increased risk of decline in physical function and the development of frailty. Two cross sectional studies found the length of hospital stay was associated with poor vitamin B12 status as assessed by MMA and serum vitamin B12 concentrations. To date there are limited studies, however, if improvements in nutrition can delay frailty progression, it could significantly enhance the independence of the increasing numbers of older people.

A meta-analysis review identified a correlation between tHcy and Alzheimer’s Disease, and suggested the effect was due to lower levels of vitamins B12, B6 and folate. These studies suggest a role for vitamin B12 in the prevention of cognitive decline. However, more long-term studies using biomarkers of vitamin B12 status and intervention studies from mid-life are needed to determine the effects of B vitamins on cognition.

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