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This Belgian study set out to examine the prevalence of thiamine (vitamin B1) deficiency in patents who had been admitted to a geriatric ward, compared to outpatient controls. The prevalence of a moderate thiamine deficiency in the elderly was found to be as high as 40% among those in hospital, but a little lower for those still at home.
Severe thiamine deficiency remains quite low. There is an ongoing controversy about the method to be used for measuring thiamine and assessing its deficiency. Direct assays probably give the best indicators but in this study thiamine status was assessed indirectly by measuring TK TPP (transketolase thiamine pyrophosphate effect).
The results confirm that thiamine deficiency is a common finding in the elderly. The thiamine deficincy is largely determined by socioeconomic features, particularly whether the patients live in an institution or a private residence.
Thiamine-deficient in-patients exhibited a higher proprtion of Alzheimer's disease, depression, cardiac failure and falls. In addition, furosemide was taken more frequently by thiamine-deficient patients.
Alcohol interferes with thiamine absorption and phosphorylation, but there were no clinical findings suggesting alcohol abuse among the subjects studied.
In earlier studies, altered axonal conduction, impaired DNA synthesis and inherited or acquired coenzyme variants also have been shown to be implicated in the pathogenesis of brain disease due to thiamine deficiency.
Furthermore, in another study, activity of thiamine-dependent enzymes was shown to be reduced in the brains of patients with Alzheimer's disease. In this study, however, a clear-cut conclusion on whether thiamine deficiency facilitates the developmnt of Alzheimer's disease was not reached.
Pepersack and co-workers conclude that the "results may suggest that thiamine deficincy facilitates the development of Alzheimer's disease. Depression and falls also appeared to be related to thiamine deficiency. The clinical relevance of thiamine deficiency on cognitive function remains a matter of debate."
Clinical relevance of thiamine status amongst hospitalised elderly patients.
Gerontology, 45 (1999)
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