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The prevalence of cobalamin deficiency has ranged from 3% to 29%.^1-3 Subtle cobalamin deficiency is defined as metabolic evidence of cobalamin deficiency, such as elevated serum or urine methylmalonate levels, or abnormal findings on a deoxyuridine suppression test, or the absence of neurological symptoms or megaloblastic anemia.⁴ The prevalence of subtle cobalamin deficiency is unknown, but in one elderly population was 39%.¹ Concerns have been raised regarding the initiation of widespread folate supplementation because it might obscure the hematologic effects of cobalamin deficiency and facilitate the progression of neuropsychiatric damage.^4-5

From May 1996 to June 1997, we invited all ambulatory patients 65 years of age or older at a large referral center, a small community Veterans Administration hospital, and a regional health maintenance organization, all in Tacoma, Wash, to participate in a free screening for cobalamin deficiency. Patients at the referral center also came from Alaska and Oregon. Exclusion criteria . . . [Full Text of this Article]

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Elevated Serum Methylmalonic Acid Concentrations Are Common among Elderly Americans ,
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J. Nutr. 2002;132:2799-2803.
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