Memory disorders with vitamin B12 deficiency – risk in advanced age

Vitamin B12 and its tasks in the nervous system

Vitamin B12 carries out many important tasks in our metabolism and, among other things, it plays a crucial role in protecting our nerves. This is true in a literal sense. Without cobalamin, also known as vitamin B12, the myelin sheaths cannot form. These surround our nerve fibers and, similar to cable insulation, they ensure proper transmission of information contained in the nerve currents. The layers surrounding the nerve fibers are used on all nerve strands, not least in the central nervous system by the spinal cord and brain as well. A sufficient vitamin B12 intake thus ensures proverbial good nerves. The vitamin also plays a role in the synthesis of hormones and neurotransmitters. If it is lacking, our nerves are thus laid bare. In the long run, there are faulty transmissions of information and thus noticeable symptoms such as abnormal sensations or, not least of all, impaired memory. These abnormal sensations, as they are otherwise referred to, are physical sensations and are not in a causal sequence with the psychological impairments.

In contrast to many other causes for severe memory disorders, a vitamin B12 deficiency can be easily treated and must therefore be detected early on.

Symptoms of a vitamin B12 deficiency: Nerve damage and memory disorders

Since vitamin B12 is stored in the liver for a long period, a deficiency in this vitamin develops gradually, over a longer amount of time. The symptoms of deficiency are varied, due to the different functions of the vitamin, and can be dismissed for a long time as a “sign of aging.” A vitamin B12 deficiency is frequently only identified when the most typical symptom of a vitamin B12 deficiency – hyperchromic anemia – develops. Hyperchromic anemia is a special form of anemia which develops due to the insufficient proliferation of red blood cells. However, when it becomes noticeable, it is often too late for early diagnosis and treatment. This is because, the neurological damage triggered by the vitamin B12 deficiency may develop much earlier without being noticed and, if it remains untreated for too long, it may be irreversible. The problem: Associating the nonspecific neurological symptoms such as gait unsteadiness, confusion and memory disorders with a possible vitamin B12 deficiency still happens far too rarely and as a result, they remain untreated for a long time. A vitamin B12 deficiency is closely linked to the risk of developing dementia which associates a low vitamin B12 level with memory disorders and early-stage Alzheimer’s dementia. This is shown in a recent study that establishes a connection between a vitamin B12 level and mild cognitive impairment.

Vitamin B12 and the causes of dementia

Dementia can of course have multiple causes. In general, vascular and neurodegenerative problems are the cause, that is, circulatory disorders in the brain and the degeneration of nerve cells. However, five to ten percent of all dementia diagnoses have a treatable cause as reported, for example, by PD Dr. Djukiv, Göttingen. A vitamin B12 deficiency plays a large role in this. However, in contrast to many other causes for severe memory disorders, a vitamin B12 deficiency can be easily treated and must therefore be detected early on. Only then can the symptoms of deficiency be controlled and even reversed, in the best case.

Diseases, medications, diet: This is why seniors are frequently affected by vitamin B12 deficiency

In 2003, a British study determined that the risk of a vitamin B12 deficiency increases with increasing age. It was shown that 10 percent of people over age 65 suffer from a vitamin B12 deficiency and 20 percent of test subjects over age 75 suffered from a deficiency. The causes of a vitamin B12 deficiency were generally due either to an inadequate vitamin intake via the diet – perhaps in the case of an unbalanced diet and poor appetite or impaired absorption of the vitamin in the gastrointestinal tract due to the natural decrease of the transport protein with age. Illnesses which can in addition impair the absorption of vitamin B12 from the intestines are chronic gastrointestinal illnesses. The administration of diabetes medications such as metformin, and proton pump inhibitors (for example omeprazole, pantoprazole) which inhibit the excess formation of gastric acid, also disrupt the absorption of vitamin B12. These factors frequently come together in the case of seniors, especially if they live in a residential facility or nursing home where meals often cannot be prepared according to each resident’s individual likes or dislikes and thus appetite is a crucial factor for many of these people. Taken together, elderly persons represent a group at risk for a vitamin B12 deficiency.

What seniors can do to combat vitamin B12 deficiency

Any suspicion of a vitamin B12 deficiency should be promptly clarified. Please discuss this with your doctor. However, a simple blood count is not the most suitable method for identifying a deficiency. A more appropriate method is a measurement of the various markers of a vitamin B12 deficiency until the diagnosis is confirmed. Then a deficiency can be easily compensated by therapy with high-dose vitamin B12 in the form of tablets or, at the start of a severe deficiency, in injections. Once the deficiency has been compensated – provided there are no absorption disorders – the recommended daily dose of 3 µg can be resumed.

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