Racial differences in prevalence of cobalamin and folate deficiencies in disabled elderly women

Sally P. Stabler, Robert H. Allen, Linda P. Fried, Marco Pahor, Steven J. Kittner, Brenda W.J.H. Penninx, Jack M. Guralnik

Research output: Contribution to journalArticle


Background: Many previous investigations of cobalamin and folate status were performed in white populations. Objective: Our objective was to determine whether there are racial differences in the prevalence of cobalamin and folate deficiency. Design: The study was a cross-sectional comparison of baseline serum cobalamin, folate, methylmalonic acid (MMA), total homocysteine (tHcy), and creatinine concentrations, complete blood count, and vitamin supplementation in 550 white and 212 African American subjects from a cohort of physically disabled older women. Results: The mean (±SD) serum MMA concentration was significantly higher in whites than in African Americans: 284 ± 229 compared with 218 ± 158 nmol/L (P = 0.0001). tHcy concentration was higher in African Americans than in whites: 12.4 ± 7.0 compared with 10.9 ± 4.6 μmol/L (P = 0.001). Serum cobalamin was lower in whites (P = 0.0002). Cobalamin deficiency (serum cobalamin <258 pmol/L and MMA >271 nmol/L) was more frequent in the white women (19% compared with 8%; P < 0.0003). Folate deficiency (serum folate <11.4 nmol/L, tHcy > 13.9 μmol/L, and MMA <271 nmol/L) was more prevalent in African Americans than in whites (5% compared with 2%; P = 0.01). Multivitamin use was associated with lower tHcy but not with MMA concentrations. Regression models showed that age >85 y, African American race, serum creatinine >90 μmol/L, and high MMA concentration were all significantly correlated with higher tHcy. Creatinine > 90 μmol/L, white race, and folate concentration were positively associated with MMA concentration. Conclusions: Cobalamin deficiency with elevated serum MMA concentration is more prevalent in elderly white than in African American women and elevated serum tHcy and folate deficiency are more prevalent in elderly African American than in white women.

Original languageEnglish (US)
Pages (from-to)911-919
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Issue number5
StatePublished - Nov 1999
Externally publishedYes


  • Cobalamin
  • Elderly
  • Folate
  • Homocysteine
  • Methylmalonic acid
  • Multivitamin use
  • Race
  • Women

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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  • Cite this

    Stabler, S. P., Allen, R. H., Fried, L. P., Pahor, M., Kittner, S. J., Penninx, B. W. J. H., & Guralnik, J. M. (1999). Racial differences in prevalence of cobalamin and folate deficiencies in disabled elderly women. American Journal of Clinical Nutrition, 70(5), 911-919. https://doi.org/10.1093/ajcn/70.5.911