Vitamin B12 screening in older inpatients without known risk factors: why do clinicians measure it?

Ting, Celia S M; Oldroyd, John C; Levinson, Michele R

doi:10.5694/mja11.11516

Topics

Gerontology

Hematologic diseases

Diagnostic techniques and procedures

Statistics, epidemiology and research design

To the Editor: Tests for serum vitamin B12 and red cell folate levels are commonly requested in elderly inpatients 1 to rule out reversible causes of cognitive impairment (eg, delirium).2 This imposes some cost on the community. The evidence for the association of cognitive impairment and vitamin B12 deficiency is inconclusive.3,4 It is also unclear whether other markers, such as elevated mean corpuscular volume (MCV) and anaemia, can indicate the need for vitamin B12 testing in elderly inpatients without known risk factors for vitamin B12 deficiency (such as coeliac disease and pernicious anaemia).

Cabrini Institute, Cabrini Health, Melbourne, VIC.

Correspondence: drtingcelia@gmail.com

Competing interests:

No relevant disclosures.

1. Medicare Australia. Medicare item reports. https://www.medicareaustralia.gov.au/statistics/mbs_item.shtml (accessed Feb 2011).
2. Pond D, Brodaty H. Diagnosis and management of dementia in general practice. Aust Fam Physician 2004; 33: 789-793.
3. Smith AD. The worldwide challenge of the dementias: a role for B vitamins and homocysteine? Food Nutr Bull 2008; 29 (2 Suppl): S143-S172.
4. Raman G, Tatsioni A, Chung M, et al. Heterogeneity and lack of good quality studies limit association between folate, vitamins B-6 and B-12, and cognitive function. J Nutr 2007; 137: 1789-1794.

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