Review article
THE EFFECT OF VITAMIN B₁₂ DEFICIENCY ON NEUROLOGICAL AND COGNITIVE HEALTH OF THE ELDERLY: A REVIEW
Mateja Ibrišimbegović
orcid.org/0000-0001-6021-8587
; Josip Juraj Strossmayer University of Osijek, Faculty of Food Technology Osijek, Franje Kuhača 18, 31000 Osijek, Croatia
Ines Banjari
orcid.org/0000-0002-8680-5007
; Josip Juraj Strossmayer University of Osijek, Faculty of Food Technology Osijek, Franje Kuhača 18, 31000 Osijek, Croatia
*
Ljubica Vazdar
orcid.org/0000-0001-6264-3675
; University Hospital Center "Sestre Milosrdnice", Clinic for Tumors, Department of Radiotherapy and Medical Oncology, Ilica 197, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Šalata 3, 10000 Zagreb, Croatia
* Corresponding author.
Abstract
Vitamin B12 (cobalamin) is an essential nutrient necessary for DNA synthesis, fatty acid metabolism, and proper function of the nervous system. In the diet, it comes almost exclusively from foods of animal origin, while plant sources contain negligible amount or inactive forms of B12. Elderly people are especially susceptible to the development of deficits due to reduced absorption, frequent chronic diseases, and use of medications that interfere with cobalamin metabolism. Subclinical deficit occurs in 15–40% of the elderly and often remains unrecognized, although it can gradually progress to neurological impairment. Absorption of vitamin B₁₂ involves complex mechanisms that depend on the function of the stomach, pancreas, and distal ileum. Malabsorption occurs in atrophic gastritis, pernicious anemia, gastrointestinal diseases, and post-surgically. Bioavailability depends on the food source; it is the highest in meat and fish, while it is significantly lower in eggs and milk. Deficiency diagnosis is complex because neurological manifestations can occur even without the presence of anemia. Evaluation includes measurement of serum vitamin B₁₂, holotranscobalamin, homocysteine, and methylmalonic acid. Modern methods, such as the CobaSorb test, enable a more accurate assessment of absorption. Vitamin B₁₂ deficiency can cause peripheral neuropathies, gait disorders, cognitive decline, psychiatric symptoms, and myelopathy, while excess often indicates more serious pathological processes such as liver, kidney, or malignancy. Timely recognition and adequate compensation are crucial in preventing permanent neurological damage, particularly among the elderly population.
Keywords
vitamin B12; food; deficiency; neurologic manifestations; elderly
Hrčak ID:
342915
URI
Publication date:
31.12.2025.
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