Dokuzlar Ozge, Soysal Pinar, Isik Ahmet Turan
Department of Geriatric Medicine, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Department of Geriatric Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey.
North Clin Istanb. 2017 May 10;4(1):22-28. doi: 10.14744/nci.2017.82787. eCollection 2017.
Frailty is associated with recurrent falls, fractures, limitation of daily living activities, cognitive impairment, increase in hospitalization, placement in nursing home, and mortality rate in older adults. Although malnutrition is one of the most important etiological factors, role of micronutrients is unclear. The aim of this study was to investigate association between frailty and vitamin B12, which has been demonstrated to be related to numerous geriatric syndromes.
Total of 335 patients who presented at geriatric outpatient clinic and underwent comprehensive geriatric assessment were included in this study. All patients were evaluated with both Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale and Fried criteria for frailty. Vitamin B12 deficiency was defined as serum vitamin B12 level of less than 400 pg/mL.
In total of 335 patients, 88 (26.3%) were assessed as frail, 156 (46.6%) were prefrail, and 91 (27.2%) were robust. When the 3 groups were compared, it was found that patients in frail group had highest average age and lowest education level (p<0.001) and that complaints of urinary incontinence, balance disorders, recurrent falls, sleep disorders, amnesia, chronic pain, and constipation were more frequent in this group (p<0.05). Albumin and 25-hydroxy vitamin D levels decreased as frailty level increased (p<0.05), but no association between vitamin B12 levels and frailty was found. Patients were divided into 2 groups: vitamin B12 level above and below 400 pg/mL. Groups were then compared in terms of subparameters of both the FRAIL and Fried criteria, and no significant difference between groups was found (p>0.05).
Results of this study determined no association between vitamin B12 level and frailty in geriatric population; however, longitudinal studies are needed to clarify relationship.
衰弱与老年人反复跌倒、骨折、日常生活活动受限、认知障碍、住院率增加、入住养老院及死亡率相关。尽管营养不良是最重要的病因之一,但微量营养素的作用尚不清楚。本研究旨在探讨衰弱与维生素B12之间的关联,维生素B12已被证明与多种老年综合征有关。
本研究纳入了335例到老年门诊就诊并接受综合老年评估的患者。所有患者均采用疲劳、抵抗力、活动能力、疾病和体重减轻(FRAIL)量表及Fried衰弱标准进行评估。维生素B12缺乏定义为血清维生素B12水平低于400 pg/mL。
335例患者中,88例(26.3%)被评估为衰弱,156例(46.6%)为衰弱前期,91例(27.2%)为非衰弱。比较这三组时发现,衰弱组患者的平均年龄最高,教育水平最低(p<0.001),且该组尿失禁、平衡障碍、反复跌倒、睡眠障碍、失忆、慢性疼痛和便秘的主诉更为常见(p<0.05)。随着衰弱程度增加,白蛋白和25-羟基维生素D水平降低(p<0.05),但未发现维生素B12水平与衰弱之间存在关联。患者被分为两组:维生素B12水平高于和低于400 pg/mL。然后比较两组在FRAIL和Fried标准的子参数方面的差异,未发现两组之间存在显著差异(p>0.05)。
本研究结果确定老年人群中维生素B12水平与衰弱之间无关联;然而,需要进行纵向研究以阐明两者之间的关系。