Prevalence and predictors of subclinical micronutrient deficiency in German older adults: Results from the population-based KORA-Age study

R Conzade,A Schneider,E Grill,M Heier,B Thorand,W Koenig

doi:10.1016/j.respe.2018.05.313

Abstract

Introduction Subclinical micronutrient deficiency in older adults is associated with chronic age-related diseases and adverse functional outcomes. In Germany, the older population is at-risk of insufficient micronutrient intake, but representative studies on micronutrient status in old and very old adults are scarce. This study's objectives were to estimate the prevalence of subclinical vitamin D, folate, vitamin B12 and iron deficiencies among older adults, aged 65 to 93, from the KORA-Age study in Augsburg, Germany (n = 1079), and to examine associated predictors. Methods Serum concentrations of 25-hydroxyvitamin D (25OHD), folate, vitamin B12, and iron were analyzed and compared to selected cut-offs for subclinical micronutrient deficiency. Associated predictors were investigated using multiple logistic regression analysis. Results The prevalence of subclinical vitamin D and vitamin B12 deficiencies were high, with 52.0% and 27.3% of individuals having low 25OHD ( Conclusion Subclinical micronutrient deficiency is a public health concern among KORA-Age participants, especially for vitamins D and B12. The predictors identified provide further rationale for screening high-risk subgroups and developing targeted public health interventions to tackle prevailing micronutrient inadequacies among older adults.

Highlights

Deficiencies in essential vitamins, minerals and trace elements affect an estimated2 billion people, in both developing and developed countries
The determination of the magnitude and predictors of subclinical micronutrient deficiency in KORA-Age older adults revealed that the prevalence of subclinical vitamin D and B12 deficiencies were high
Our population-based data is in line with previous studies that have suggested that subclinical vitamin D and B12 deficiencies are prevalent public health problems among older adults [12,15,38,39,40,41,42]

Summary

Introduction

2 billion people, in both developing and developed countries. This ‘hidden hunger’ has negative health impacts among vulnerable groups in the population, especially older adults [1]. Epidemiological evidence suggests that subclinical micronutrient deficiencies in older adults are associated with chronic age-related diseases and adverse functional outcomes. 25-hydroxyvitamin D (25OHD) levels have a significantly higher risk for type 2 diabetes mellitus, cardiovascular disease (CVD) and osteoporosis-related fractures [2]. Age-associated declines in muscle mass and strength (sarcopenia), which in turn affect balance, gait, and overall independence [3], have been linked to low 25OHD levels as well [4]. Vitamin B12 and folate are necessary for one-carbon metabolism and DNA synthesis, and have been investigated in relation to degenerative diseases, including CVD, cognitive dysfunction and osteoporosis [5]. Iron deficiency is the most prevalent nutritional deficiency worldwide and its main consequence is anemia [6], which has been associated with an increased risk of developing dementia in old age [7]

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Conclusion