Vitamins and Seniors’ Health

Life is relatively more precarious at the extremes of life. Age-related illnesses are common among seniors. The rates of common colds and other respiratory tract infections are high in this age group, increasing morbidity, and mortality, and healthcare services utilization. Supplementation with vitamin E improves immune response in the elderly1, 2. The implication of this for the health and well-being of the elderly, not to mention healthcare costs, is self-evident. Seniors also benefit from vitamin C.

A recent 5-year study shows that vitamin C supplementation significantly reduces the rate of the common cold3, an earlier study4 that the effects on the duration and severity of cold symptoms of mega-doses of vitamin C (over 1 g daily) taken soon after the onset of a cold did not differ significantly from those with doses less than the minimum recommended daily dose (300mg), the latter doses even resulting in shorter duration and reduced severity of the cod symptoms.

The role that some other vitamins play regarding the health of the elderly is more controversial. Consider for instance vitamin B-12 deficiency, which affects many seniors due to loss of ‘stomach wall cells’, particularly those with chronic gastritis, resulting in pernicious anemia. That treatment of pernicious anemia with high-level folic acid fortification delays the diagnosis of or worsens vitamin B-12 deficiency symptoms, as some studies show, is instructive, as do that other studies reveal a link between high serum folate and anemia and cognitive impairment in seniors with low vitamin B-12 status, but with normal vitamin B-12 status, high serum folate protecting against cognitive impairment5.

Folic acid food fortification for the elderly is increasingly prevalent in many health jurisdictions, as are questions regarding the benefits or otherwise of adding vitamin B-12 to such folate fortified foods, the introduction of folic acid food fortification linked with a considerable improvement in the folate status of Canadian women aged 65 years and older, although not so pronounced, improvement in their B-12 status, according to one study6. In the U.S., flour has been fortified with folic acid since 1998, to lower the risk of women having children with neural tube defects. This has not only helped in this regard, but also has resulted in a decrease in the prevalence of folate deficiency in general in the country.

Many other countries now also fortify foods with folic acid. Indeed, every segment of the population seems to benefit from folic acid fortification, but the need to keep monitoring vitamin B levels is crucial7. Besides impaired cognitive function and demetia8, the link between low folate levels and depression is also well known9.

Given these various links, among others, some researchers have examined the adequacy or otherwise of the customary approach for example of developing menus for the elderly such as in long-term care facilities (LTC), using resources such as Canada's Food Guide or the U.S Food Guide Pyramid, which some claim lead to iatrogenic malnutrition, that is, due to flaws perpetuated by those looking after the seniors10. This has led to calls for new guidelines targeted toward the special needs of older adults who generally do not eat much, including comprehensive vitamin and mineral supplementations.

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