Relationship of vitamin B12 deficiency with incontinence in older people

[Vitamin B12 and folic acid deficiency in the population over 65 years: a descriptive study]

INTRODUCTION

The aim of this study is to establish the prevalence of vitamin B12 and folic acid deficiency in the population of 65 years and over in semi-urban and rural area, as well as investigating the risk factors, and the determining factors of this deficiency in this population and its relationship with the prevalence of concomitant cardiovascular and cognitive diseases.

MATERIALS AND METHODS

A cross-sectrionall study conducted in the Geriatrics Outpatients in the period between 2008 and 2010. Demographic, clinical and laboratory were collected at 3 different times.A bivariate analysis was performed with lack of vitamin B12 and folic acid, as the outcome variables.

RESULTS

Vitamin B12 defieciency was found in 16.5% of the sample, and no folic acid deficiency. A strong association was found with vitamin B12 deficiency and cardiac and cerebrovascular diseases, vascular risk factors and drugs administered in prevention of cardiac events and ischaemic stroke.

CONCLUSIONS

There was a higher prevalence of vitamin B12 deficiency in the elderly population in the catchment area of Medina del Campo compared to that found in the literature, but not so with the isolated deficiency of folic acid.

The association of diet and other lifestyle factors with the onset of overactive bladder: a longitudinal study in men

Objective:

To investigate associations between diet and non-dietary lifestyle factors and the onset of overactive bladder (OAB) in men.

Subjects:

Random sample of community-dwelling men aged 40 years plus.

Design and methods: Baseline data on urinary symptoms and diet were collected from 5454 men using a postal questionnaire and a food-frequency questionnaire. Follow-up data on urinary symptoms were collected from 4887 men in a postal survey one year later. Logistic regression analysis was used to investigate diet and lifestyle factors associated with onset of OAB in the men without OAB at baseline.

Results:

There was a highly significant negative association between beer intake at baseline and subsequent OAB onset (P = 0.001), with reduced risk at all levels of intake compared with those who seldom/never drank beer. Adjustment for total alcohol intake (g ethanol day−1) reduced the significance of the association (P = 0.02). None of the food groups studied was associated with OAB onset, with the possible exception of potatoes (P = 0.05), which showed an increased risk of onset at the highest level of consumption. Physical activity, smoking and obesity were not significantly associated.

Conclusions:

While most diet and lifestyle factors were not associated with OAB onset, the evidence from this prospective longitudinal study suggests that beer may have a protective role in the development of OAB. This could be due to a non-alcoholic ingredient as well as the alcohol content.

Nutrient composition of the diet and the development of overactive bladder: A longitudinal study in women

AIMS

Evidence for an association between diet and the symptom syndrome overactive bladder (OAB) would be valuable in understanding its aetiology. The present study investigates prospectively the association between the nutrient composition of the diet and the onset of OAB.

METHODS

A random sample of community dwelling women aged 40 years or over was studied. Baseline data on urinary symptoms and diet were collected from 6,371 women using a postal questionnaire and food frequency questionnaire. Follow-up data on urinary symptoms were collected from 5,816 of the women in a postal survey 1 year later. Logistic regression was used to investigate the association of diet (daily intakes of energy, macro and micronutrients) with 1 year incidence of OAB.

RESULTS

There was evidence that three nutrients may be associated with OAB onset. Higher intakes of vitamin D (P = 0.008), protein (P = 0.03), and potassium (P = 0.05) were significantly associated with decreased risks of onset. Although overall the associations with vitamin B6 and niacin were not significant (P = 0.08 and P = 0.13), there was some evidence of a decreased risk of onset with higher intakes.

CONCLUSIONS

The results from this prospective study suggest possible aetiological associations between certain nutrients and OAB onset. The findings need confirmation and possible mechanisms to explain these associations need further investigation.

An association between Helicobacter pylori infection and serum vitamin B12 levels in healthy adults

GOALS

To determine whether serum vitamin B12 levels in non-vitamin B12 deficient healthy adults correlate with serological evidence of H. pylori infection.

BACKGROUND

An association between H. pylori infection and vitamin B12 deficiency has been recently reported.

STUDY

133 adults, presenting to a community based primary care clinic who met the following exclusion criteria; history of H. pylori eradication or antacid use, liver disease, inflammatory bowel disease, previous gastrointestinal surgery, a vegetarian diet or multivitamin supplementation were studied. Blood was drawn for a complete blood count, serum vitamin B12, gastrin, folic acid and H. pylori IgG antibodies. Subjects with vitamin B12 < or = 145 ng/mL (deficient range) were excluded.

RESULTS

Of 133 subjects 96 (72.2%) were seropositive for H. pylori IgG antibodies (HP+). Age of HP(+) subjects did not differ from that of seronegative subjects (HP-); 52.8 +/- 1.6 mean +/- SE versus 49.2 +/- 2.9 ( = NS). Prevalence of HP seropositivity was significantly higher among subjects with borderline (>145-180 pg/mL) or low normal (>180-250 pg/mL) vitamin B12 levels than among those with vitamin B12 > 250 pg/mL; among 25 subjects with vitamin B12 > 145-180 pg/mL 92% were seropositive and among 47 subjects with vitamin B12 > 180-250 pg/mL 89% were seropositive as compared with 31/61 (51%) of subjects with B12 > 250 pg/mL, Fisher exact test < 0.0001. Vitamin B12 levels did not correlate with age (r = -0.07). Gastrin levels (pg/mL) did not differ significantly between groups; 70.2 +/- 5.8 in HP(+) versus 56.0 +/- 12.4 in HP(-).

CONCLUSIONS

The higher prevalence of H. pylori infection among subjects with serum vitamin B12 levels that are within the lower end of the normal range suggests a causal relationship between H pylori infection and vitamin B12 levels in healthy adults.

Vitamin B(12) deficiency and incontinence: is there an association?

BACKGROUND

This study investigated the relationship between B(12) (cobalamin) levels and incontinence in older outpatients using secondary data analysis.

METHODS

Between 1991 and 1999, there were 929 patients (258 men and 671 women) for whom urinary incontinence (UI), fecal incontinence (FI), and B(12) were prospectively recorded. Covariates included race, gender, age, medications, Mini-Mental State Examination, modified illness rating, and instrumental activities of daily living (IADLs).

RESULTS

Some form of incontinence (UI or FI or both) was found in 41% of subjects, isolated UI in 34%, double incontinence (DI) in 12%, and isolated FI in 4%. Having UI increased the risk of also having FI (p <.0001). Serum B(12) levels of 300 pg/ml or less were not predictive of isolated UI or isolated FI. However, in logistic regression, DI was predicted by B(12) (odds ratio [OR] = 2.113, p =.0094), IADLs (OR = 0.810, p <.0001), cathartics/laxative use (OR = 1.902, p =.126), and diuretic use (OR = 2.226, p =.006). Considering isolated UI in women, higher IADLs reduced risk of UI (OR = 0.956, p =.002), while diuretics (OR = 1.481, p =.041) and antihistamines (OR = 1.909, p =.046) both increased risk of UI. In men, only use of anticonvulsant medications (OR = 4.529, p =.023) increased risk of isolated UI. Greater physical illness in both genders increased risk of isolated FI (OR = 1.204, p =.006).

CONCLUSIONS

These findings suggest that serum B(12) at levels of 300 pg/ml or less are not associated with isolated UI or isolated FI but may play a role in DI. A possible association of low B(12) levels with DI is intriguing because of the implications for treatment and prevention. More immediately, medication side effects should be considered when evaluating this problem.