Consider intramuscular injections for older people with vitamin B12 deficiency, says NICE

Clinicians should consider the use of intramuscular injections for people with vitamin B12 deficiency when there are concerns about adherence to oral replacement, say draft guidelines from the National Institute for Health and Care Excellence (NICE).This may apply to older people who are in or have recently been in hospital and also have complex comorbidity, or have frailty linked to undernutrition, dementia, or decompensation, NICE says.The draft guideline1 is NICE’s first for diagnosing and managing vitamin B12 deficiency. It highlights that older people are among the most at risk of vitamin B12 deficiency, particularly those 65 and over, with one in 10 over 75s estimated to be affected.If untreated, vitamin B12 deficiency can lead to health complications including anaemia and tiredness, eyesight problems such as blurred vision, mobility problems such as impaired balance, and delirium (acute confusion), it said.DiagnosisThe guidance recommends that a blood test for vitamin B12 deficiency should…
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