The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:M354-M361 (2003)
© 2003 The Gerontological Society of America
News and Views on Folate and Elderly Persons
Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Section of Geriatrics, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
Elderly persons are especially exposed to folate deficiency, where normal/subnormal folate levels do not exclude tissue deficiency. Accompanying diseases, medication, and lifestyle factors may contribute to/cause deficiency. Symptoms of deficiency can be hematological, neurological, or neuropsychiatric, but it is likely that there are also cardiovascular manifestations as well as associations with malignancies. The physician should make an individualized investigation to establish the probable cause. Among the available determinants of the folate/cobalamin state, plasma homocysteine (Hcy) is a swift and sensitive marker and has the strongest connection to cognitive function. The association is generally stronger between Hcy levels and symptoms than between vitamin-related levels and symptoms. The duration as well as the severity of symptoms are of importance in terms of the improvement of neurological and neuropsychiatric symptoms when substitution is performed. The issue of general folate fortification of flour is complex, and there are as many pros and cons as there are countries in which it is considered to be launched. It is important to bear in mind that in our modern society, deficiency of folate/cobalaminovert or latentmainly is a problem of the elderly and a challenge to the doctor.
Copyright © 2003 by The Gerontological Society of America.