As people get older, their ability to absorb vitamin B12 decreases, and this is because aging adults often develop problems with the acids and stomach enzymes needed to process the vitamin. Common risk factors for low vitamin B12 levels in older adults include:
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Low levels of stomach acid. This can be due to weakening of the stomach lining (also known as “atrophic gastritis”), or to medications that reduce stomach acid.
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Pernicious anemia, which makes it hard for your body to absorb vitamin B12.
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Atrophic gastritis, in which your stomach lining has thinned.
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Malabsorption, which accounts for the majority of cases of vitamin B12 deficiency in elderly persons.
Mild vitamin B12 deficiency in otherwise healthy individuals can result from dietary patterns that result in insufficient dietary intake of animal source foods. Vitamin B12 deficiency is often missed because the symptoms, such as fatigue, anemia, neuropathy, memory problems, or walking difficulties, are quite common in older adults, and can easily be caused by something else. Also, vitamin B12 deficiency tends to come on very slowly, so people often go through a long period of being mildly deficient. During this time, an older person might have barely noticeable symptoms, or the symptoms might be attributed to another chronic health condition.
