Changes in the Vitamin Status of Elderly Europeans: Plasma Vitamins A, E, B-6, B-12, Folic Acid and Carotenoids. SENECA Investigators

Objective: Determination of the plasma vitamin and carotenoid concentrations of a number of elderly populations to describe their micronutrient status and examine geographical patterns and the cross-sectional and longitudinal relationships with sex, age, food and alcohol intake.

Design: Longitudinal study.

Setting: Twelve small towns in ten European countries and one in the USA.

Subjects: Randomized sample of 1175 subjects of both sexes born in the period 1913-1918, stratified according to age and sex.

Interventions: Blood plasma collection and determination of alpha-tocopherol, gamma-tocopherol, alpha-carotene, all-trans- and cis-beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin, vitamin B-12, folic acid and pyridoxal 5'-phosphate. From the original sample examined in 1988/1989, measurements were repeated in 938 subjects in 1993.

Results: There were very large within and between country differences in the micronutrient levels with no definite geographical pattern emerging. The retinol levels decreased significantly between 1988/1989 and 1993 (-0.2 mumol/l, P = 0.0001), unlike the total carotene levels (0.01, NS) while the alpha-tocopherol (0.7 mumol/l, P = 0.002), folic acid (1.1 nmol/l, P < 0.01) and pyridoxal 5'-phosphate (12 nmol/l, P = 0.0001) levels increased significantly. Vitamin B-12 levels increased nonsignificantly in men (17.2 pmol/l, P = 0.77) and decreased significantly in women (-37 pmol/l, P = 0.012). The prevalence of biochemical vitamin A deficiency was zero in both 1988/1989 and 1993, that of vitamin E deficiency decreased from 1.1% to 0.6% and for vitamin B-6 from 23.3% to 5.7%. Vitamin B-12 biochemical deficiency increased from 2.7% to 7.3% and for folic acid from zero to 0.3%.

Conclusions: Changes in the median micronutrient plasma levels over a 4-y period varied, exceeding 30%-40% in some elderly populations. This was reflected in changes, mostly decreases, in the prevalences of vitamin deficiency.