“These findings suggest that vitamin D status should remain a clinical priority in geriatric assessment, while the presence of concurrent B12 deficiency may help identify patients at particularly elevated risk of cognitive and affective decline,” wrote researchers at the University of Medicine and Pharmacy in Romania in Nutrients.
However, given the study’s methodology, they noted that some observations should be regarded as preliminary.
Micronutrient status in geriatric decline
Micronutrient status has been increasingly recognized as a contributing and modifiable factor in the health and quality of life of older generations.
An aging population means that there is an increasing number of older adults living with cognitive impairments, depressive symptoms, and dependency on health and social care systems.
Vitamin D and vitamin B12 have been studied separately for their influence on these outcomes, but there is comparatively less research on their combined effects in older populations.
Recent studies conclude that nearly 60% of elderly adults have vitamin D deficiency, which is a crucial factor contributing to disease susceptibility and mortality. Reasons for a lack of vitamin D can include reduced sunlight exposure due to hospitalization, frailty, and skin color, lower dietary intake, and age-related changes in organ function.
Risk of vitamin B12 deficiency increases with age and is linked to anemia, cognitive decline, and dementia. Reasons for deficiency include malabsorption due to low stomach acid and gut dysfunction, as well as common medications such as proton pump inhibitors and metformin, which also affect absorption.
Study details
The observational study included 1359 patients aged over 65 from the geriatric department of a Romanian hospital.
Between January 2023 and April 2026, the patients underwent a full geriatric assessment, which included measurements of serum 25-hydroxyvitamin D and vitamin B12, as well as other micronutrient and inflammatory markers.
The researchers found that 7.1% had co-deficiency of vitamin D and B12.
“Isolated vitamin D deficiency was independently associated with poorer cognition and greater frailty, while isolated B12 deficiency showed no association with any outcome,” they wrote.
“Co-deficient patients carried the heaviest cognitive burden of all groups and showed a signal of elevated depressive symptoms that was significant at the primary B12 threshold but attenuated at an alternative threshold, indicating this finding should be interpreted cautiously; no interaction term reached significance.”
The researchers recommended future studies incorporating folate and musculoskeletal outcomes to identify the clinical benefit of correcting both deficiencies.
Source: Nutrients, https://doi.org/10.3390/nu18183078 “The Double-Deficient Older Inpatient: Vitamin D and Vitamin B12 Co-Deficiency Identifies the Greatest Cognitive and Affective Burden.”, Authors: L. Avram et al.
