Intake of medication and vitamin status in the elderly.

BACKGROUND/AIMS: An inadequate vitamin status is associated with higher morbidity and frailty in the elderly and might be due to medication. This study aimed to evaluate the status of several vitamins in relation to regular intake of medication in this population. METHODS: A total of 102 non-institutionalized subjects aged 70-90 years were recruited. Plasma levels of vitamins A, D, E, K and C were determined by HPLC. The functional parameters of vitamins B(1), B(2) and B(6), i.e. the activities of the erythrocyte enzymes transketolase, glutathione reductase and glutamic oxaloacetic transaminase were analyzed photometrically; plasma folate and vitamin B(12) were determined by RIA. RESULTS: The status of vitamins A, E and C was generally satisfactory. Eighty-eight percent and 42% of participants were deficient in vitamins D and K, respectively, as were 29% in B(6); up to 10% were deficient in vitamins B(1), B(2), B(12) and folate. A considerable percentage of participants was, however, at risk for vitamin deficiencies (vitamins B(1), B(6), B(12) and folate: 20-30%; vitamin B(2): 60%). Regular intake of maximally 2 drugs per day was not adversely related to the status of several vitamins; intake of ≥ 3 drugs per day was significantly negatively associated with the status of vitamins D, K, B(6) and folate. CONCLUSION: Daily intake of ≥ 3 drugs was found to be adversely associated with the status of some vitamins in the elderly. Hence, the medication schedule and nutritional status of these subjects should be monitored closely to ensure that the daily micronutrient requirement is fulfilled.

Homocysteine and asymmetric dimethylarginine in relation to B vitamins in elderly people.

OBJECTIVE: Homocysteine is a cardiovascular risk factor, its metabolism is influenced by certain B vitamins and it is associated with endothelial dysfunction probably due to impaired bioavailability of NO caused by homocysteine-induced accumulation of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase. On this basis, we investigated the cardiovascular risk factors homocysteine and ADMA in relation to vitamins B(6), B(12) and folate in elderly people. METHODS: A total of 102 subjects were recruited and divided into three groups according to age: A (70-74y, n = 48), B (75-79y, n = 35) and C (≥80y, n = 19). Plasma levels of vitamin B(6) were determined with HPLC, vitamin B(12) and folate by RIA. Plasma concentrations of homocysteine were analyzed with HPLC and levels of ADMA were measured by ELISA. RESULTS: Plasma levels of vitamins B(6), B(12) and folate were found to be adequate in 93, 67 and 55% of participants, respectively. This study showed a significant age-associated decrease in vitamins B(6) (A > B, A > C: p < 0.05), B(12) and folate (A > C: p < 0.05) in parallel to a significant age-related increase in the cardiovascular risk factors homocysteine (A < C, B < C: p < 0.05) and ADMA (A < B: p < 0.05; A < C: p < 0.001). Moreover, homocysteine was significantly negatively (p < 0.01) related to vitamins B(6), B(12) and folate, and significantly positively (p < 0.01) correlated to ADMA. CONCLUSIONS: The significant correlation between homocysteine and ADMA observed in this study may be an important mechanism decreasing NO bioavailability and so causing endothelial dysfunction. Due to the significant relation of vitamins B(6), B(12) and folate to plasma homocysteine, these vitamins may thus indirectly influence endothelial function and cardiovascular risk in elderly people.