Experts warn: Among the elderly, nutrient deficiency is often underestimated!

November 2018

Hamburg - Various studies have proven that elderly people often do not receive sufficient vitamins and minerals. A deficiency of biofactors can adversely affect physical and mental performance and promote typical age-related diseases, scientists and physicians warned at a symposium of the Gesellschaft für Biofaktoren e.V. (Society for Biofactors) on 10 November in Hamburg. The experts therefore advised keeping an eye on possible nutritional deficiencies in seniors and treating these in a timely manner.

Elderly people are exposed to a multitude of mutually reinforcing factors that can have a highly negative effect on biofactor supply: “During the ageing process, the efficiency of the gastrointestinal tract constantly decreases,” explained pharmacologist Prof. Dr. Dr. med. Dieter Loew. As a result, it is more difficult for the body to absorb vitamins and minerals from food. At the same time, many seniors take in fewer vitamins and minerals through food. Critical nutrition supply is exacerbated by chronic illnesses and the related treatment with medications. Both can greatly increase the need for vitamins and minerals and thus lead to deficiency situations, stressed Dr. des. Uwe Gröber, pharmacist and director of the Akademie für Mikronährstoffmedizin (Academy for Micronutrient Medicine) in Essen. 40% of patients who are treated with medication take 9 or more drugs daily(1). This results in complex interactions with vitamins and minerals, which put these persons at a particularly high risk for deficiencies, according to Gröber. If these are not recognized and countered in a timely fashion, serious consequences may result: these range from a weakened immune system and lack of vitality to nerve damage, dementia, osteoporosis, and the worsening of existing illnesses.

Vitamin B-deficiency gets on the nerves
For example, a deficiency of vitamin B1 can quickly lead to a decline in the efficiency of various parts of the nervous system, explained Prof. Dr. med. Karlheinz Reiners. For one thing, this could affect the brain: slight deficiencies were marked by difficulties concentrating, forgetfulness, or orientation disorders - at the worst, dementia can develop, warns the neurologist. Often, even the long nerve pathways are damaged, which lead to the hands and feet. This so-called polyneuropathy therefore usually manifests itself in sensitivity disorders, such as tingling, burning, or numbness in the hands and feet. People who suffer from diabetes mellitus are at an increased risk for vitamin B1 deficiency, for example, because they secrete more of the vitamin through the kidneys. At the same time, many diabetics are affected by polyneuropathy as a result of their metabolic disorder, meaning that these patients must absolutely avoid a vitamin B1 deficiency or compensate for this, stressed Reiners. Here, intake of the vitamin’s derivative, benfotiamine, is advantageous. It can be much more easily absorbed by the body, which means that the vitamin reaches the nerve tissue in sufficiently high concentrations.

Vitamin B12-deficiency widespread among the elderly
Elderly people also have a higher risk for vitamin B12-deficiency: according to a current study, every fourth person over the age of 65 is affected by this in Germany(2). In addition to the insufficient quality of the food, a major cause for the widespread deficiency among elderly is a disrupted absorption of the vitamin in the intestines. From a psychiatric point of view, a vitamin B12-deficiency can lead to depressive moods and cognitive declines, up to and including dementia. In up to 30 % of patients with cognitive disorders, a treatable cause can be found, explained Prof. Dr. med. Marija Djukic. In patients where there is a suspicion of dementia, a deficiency of vitamin B12 actually proved to be the second most common treatable cause of the illness(3). Djukic advises having the vitamin status investigated early on as neurological symptoms can be irreversible if they are treated too late.

Magnesium deficiency damages heart and blood vessels
Particularly in conjunction with internal diseases, such as high blood pressure, heart failure, arteriosclerosis, lipometabolic disorders, and diabetes mellitus, one often observes magnesium deficiencies in many older people, as reported by Prof. Dr. med. Klaus Kisters. In all cases, these deficiencies must be compensated for, according to the specialist for internal medicine, nephrology, clinical geriatrics, and hypertension. Otherwise, new illnesses can occur or existing illnesses can worsen, warned Kisters.

Biofactors for bone health
A combined deficiency of magnesium and vitamin D also commonly occurs in patients with osteoporosis and muscular atrophy (sarcopenia). Both magnesium and vitamin D are of crucial importance for bone health, whereas there is a close interaction between the two biofactors in the metabolism: Vitamin D promotes magnesium absorption in the small intestine. Conversely, magnesium is needed in order to convert vitamin D to its active form. Deficiencies of these two biofactors can therefore mutually exacerbate each other, explained Kisters. With regard to the increasing risk for osteoporosis in women after menopause, it is therefore important to ensure sufficient provision of both nutrients and to supplement these as needed, according to the expert.

Consider zinc deficiency in cases of susceptibility to infection and skin problems!
The menus of elderly people also often contain too little zinc: 44% of men and 27% of women aged 65 to 80 get less zinc through their food than is recommended to cover their daily requirements, explained the pharmacologist Prof. Dr. med. Tilmann Ott, pointing to the results of the German National Consumption Study II(4). As Ott pointed out, a zinc deficiency is connected to various symptoms, which often occur in the elderly. For example, these include delayed wound healing, skin diseases, smell and taste disorders, and decreased immune defence with increased susceptibility to infection.

Keeping an eye on biofactor intake
Prof. Dr. med. Hans-Georg Classen, Chairman of the GfB, pointed out that the intake recommendations on which the national consumption study is based refer to healthy individuals. They do not take into account any increased requirement due to illnesses, drugs, or stress. It is therefore to be expected that a deficiency of biofactors in elderly persons is a common, but too-seldom diagnosed event, summarized Classen. The experts therefore recommended paying more attention to biofactor intake among the elderly, countering deficiencies with targeted measures in order to maintain the best possible health, vitality, and quality of life.

Source:
Specialist symposium of the Gesellschaft für Biofaktoren e.V.: “Risikogruppen einer kritischen Versorgung mit Biofaktoren: Der alternde Mensch im Fokus” (Risk groups for a critical supply of biofactors: the focus is on the elderly) on 10 November 2018 in Hamburg
(1) Gröber U, Schmidt J, Kisters K, Important drug micronutrient interactions: A selection for clinical practice. Crit Rev Food Sci Nutr, 2018 (Epub ahead).
(2) Conzade R, Koenig W, Heier M, Schneider A, Grill E, Peters A, Thorand B: Prevalence and predictors of subclinical micronutrient deficiency in German older adults: results from the population-based KORA-Age Study. Nutrients 2017; 9, 1276; DOI: 10.3390/nu9121276
(3) Djukic M, Wedekind D, Franz A, Gremke M, Nau R: Frequency of dementia syndromes with a potentially treatable cause in geriatric in-patients: analysis of a 1-year interval. Eur Arch Psychiatry Clin Neurosci 265 (5), 429-38, 2015
(4) Max-Rubner-Institut, Bundesforschungsinstitut für Ernährung und Lebensmittel: Nationale Verzehrsstudie II, 2008.

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