VARIOUS DEGREES OF DEMENTIA IN A SELECTED GROUP OF GASTRECTOMIZED PATIENTS WITH LOW SERUM B₁₂

Abstract

Forty-two gastrectomized patients (mean age 56 years) with a serum B12 level less than 200 pg/ml were studied by psychological testing and electroencephalography. A total of 50 per cent exhibited mild to moderate or more severe intellectual impairment, judging by the history and psychological testing. EEG abnormalities were found, mainly in the form of reduced dominant activity, in 48 per cent. The results of psychological testing were in accurate conformity with the findings of dementia due to other reasons. The characteristic findings were depression and lability of affect, with a high frequency of suicidal attempts (20 per cent). We interpret the cerebral abnormalities as a result of vitamin B12 deficiency.

Cobalamin deficiency, hyperhomocysteinemia, and dementia

“…H2 receptor blockers and PPIs impair cobalamin absorption; 18,22,33,365,366 their use is associated with supplemental B12 initiation 367. Individuals who have had gastric surgery have a high prevalence of B12 deficiency,20 and those who have had gastrectomies, who are B12-deficient, have a high prevalence of cognitive dysfunction and electroencephalographic (EEG) abnormalities 332. Therefore, patients prescribed H2 receptor blockers or PPIs, and those who have had gastrectomies or gastric bypass surgery, require monitoring for hypovitaminosis B12 368…”

Use of rCBF in diagnosis and follow‐up of cerebral vitamin B12 deficiency

“…A somewhat lower incidence has previously been reported in patients with B 12 deficiency (Roos and Willanger, 1977;Scheinberg, 195 1). This discrepancy can be explained by coexisting organic brain diseases in some of our patients.…”

“…This discrepancy can be explained by coexisting organic brain diseases in some of our patients. However, previous electrophysiological studies indicate a much more frequent involvement of the nervous system in B12 deficiency states than is recognized (Roos and Willanger, 1977;Scheinberg, 1951;Lockner et al, 1969), sometimes complicated by visual impairment and loss of colour perception (Enoksson and Nordkn, 1960).…”

National Disease Management Guidelines - Diabetes

“…A rigid curriculum is not reasonable [67]. Parents need differentiated education programmes that correspond to the respective educational and developmental tasks based on the age of the child [68][69][70]. Education programmes that are part of continuous, long-term care and include the parents show positive effects on the quality of the metabolic situation, knowledge of the diabetes, therapy behaviour, self-management skills, psycho-social integration and quality of life [71,72].…”