Are older adults with hip fractures a specific risk group for vitamin B12 deficiency?

Background

Hip fractures (HF) are a high-impact geriatric syndrome. Vitamin B12 deficiency is an HF risk factor. There are few studies on prevalence of B12 deficiency in older adults with HF. The objectives are as follows: in older adults with HF, to describe/characterize plasma levels of vitamin B12 (PL-B12); to verify presence/absence of a subgroup with borderline, near-deficient PLB12; to describe HF incidence; and to analyse relationships between PL-B12 and studied variables.

Methods

Cross-sectional, observational study, analytical component. Complete Collection sample (01.08.2016–31.08.2018). Variables: PL-B12, age, sex, HF location, time of year, in-hospital stay length. Medians/percentiles, non-parametric tests. PL-B12 cut-off points according to the WHO, proposing new cut-off points to capture borderline values.

Results

A total of 580 subjects. HF incidence = 264/100 000 ≥ 65 years, 79% female, 72% extracapsular HF. Medians: age = 83 years; PL-B12 = 349 pg/cc; hospitalization = 13 days. Significantly lower PL-B12 in males (P = 0.023) and extracapsular fractures (P = 0.013). No significant differences between age groups, length of hospitalization, and season of the year. Thirty-five per cent B12 deficiency (16% deficiency and 19% mild deficiency). By increasing cut-off point for deficiency to 400 pg/cc, prevalence increased to 58%.

Conclusions

High prevalence of vitamin B12 deficiency among older adults with HF, significantly higher in men and extracapsular HF. Twenty-four per cent normal PL-B12 according to WHO criteria, but with borderline, near-deficient levels, at the time of HF. In older adults with HF, we recommend measuring PL-B12 and raising the cut-off level required to diagnose deficiency. We consider that older adults with HF are a specific risk group for vitamin B12 deficiency.