Folate status in the elderly.

It is only within recent years that a satisfactory method for estimating the serum folate level has been available, and since this test was introduced a number of investigators have reported the occurrence of nutritional megaloblastic anaemia due to folic acid deficiency in the United Kingdom, particularly in elderly persons (Gough, Read, McCarthy, and Waters, 1963 ; Varadi and Elwis, 1964; Forshaw, Moorhouse, and Harwood, 1964, 1965). However, as has been previously reported, nutritional megaloblastic anaemia has not been seen in the South-east of Scotland (Girdwood, 1960a, 1964) ; hence it was decided to make use of a study of elderly persons, which was being undertaken for other purposes, to assess the serum folate level of a number of geriatric subjects in the region. In 1965 Read, Gough, Pardoe, and Nicholas reported studies of the nutritional status of 51 consecutive subjects on arrival at an old people's home in Bristol. Only 10 of these had serum folate levels within their accepted normal range of 6-21 mpg./ ml., and in 10 the reading was less than 3 mpLg./ml. The excretion of formiminoglutamic acid after a histidine load test (Kohn, Mollin, and Rosenbach, 1961) was excessive in 62% of the subjects, and this was thought to give further evidence of deficiency. Low serum vitamin-B12 levels were not a feature. More recently Hurdle and Williams (1966) reported low levels of serum folate in 28 out of 72 persons over the age of 70 admitted to a geriatric hospital in South London.