Subscribe to RSS
DOI: 10.1055/a-2338-8856
Der ältere Mensch in der Praxis – Biofaktoren im Fokus
![](https://www.thieme-connect.de/media/OM/202402/lookinside/thumbnails/23388856_10.1055-a-2338-8856-1.jpg)
Zusammenfassung
Gerade ältere Menschen haben ein erhöhtes Risiko für einen ernährungs- oder krankheitsbedingten Mangel an essenziellen Biofaktoren wie Vitamine und Mineralstoffe. Auch die im Alter oft praktizierte Multimedikation kann dazu beitragen. Der Biofaktorenmangel kann die körperliche und geistige Leistungsfähigkeit betroffener Senioren beeinträchtigen, zu Erkrankungen wie die des Herz-Kreislauf-Systems, Diabetes oder Demenz führen oder diese verschlimmern. Aufgrund des großen Anteils älterer Patienten in der Praxis sollte daher die Biofaktorenversorgung u. a. mit Vitamin B12, Vitamin D3 und Magnesium dieser Risikogruppe gezielt beobachtet werden.
Publication History
Article published online:
17 July 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart,
Germany
-
Literatur
- 1 Heseker H. et al. ErnSTES-Studie. In: DGE, Hrsg. Ernährungsbericht. 2008: 157-204
- 2 Deutsche Gesellschaft für Ernährung e. V. Referenzwerte https://www.dge.de/wissenschaft/referenzwerte/ (Stand: 07.06.2024)
- 3 Assis BS. et al. Micronutrient intake in elderly living in nursing homes. Nutr Hosp 2018; 35: 59-64
- 4 Vural Z. et al. Trace mineral intake and deficiencies in older adults living in the community and institutions: A systematic review. Nutrients 2020; 12: 1072
- 5 Conzade R. et al. Prevalence and predictors of subclinical micronutrient deficiency in german older adults: Results from the Population-Based KORA-Age Study. Nutrients 2017; 9: 1276
- 6 Keum N. et al. Vitamin D supplementation and total cancer incidence and mortality: a meta-analysis of randomized controlled trials. Ann Oncol 2019; 30: 733-743
- 7 Mohn ES. et al. Evidence of Drug-Nutrient interactions with chronic use of commonly prescribed medications: An update. Pharmaceutics 2018; 10: 36
- 8 Gröber U, Kisters K. Arzneimittel als Mikronährstoff-Räuber. Stuttgart: Wissenschaftliche Verlagsgesellschaft; 2022
- 9 Gröber U. Arzneimittel und Mikronährstoffe. 2. Aufl. Stuttgart: Wissenschaftliche Verlagsgesellschaft; 2016
- 10 Neuner-Jehle S. Polypharmazie bei Älteren. Prim Hosp Care Allg Inn Med. 2019 19. 113-115 https://phc.swisshealthweb.ch/de/article/doi/phc-d.2019.10047/
- 11 Andrès E. et al. Vitamin B12 deficiency in elderly patients. CMAJ 2004; 171: 251-259
- 12 Djukic M. et al. B-Vitamine in der in der Geriatrie – was bestimmen, was ersetzen?. Dtsch Med Wochenschr 2021; 146: 152-156
- 13 Lam JR. et al. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013; 310: 2435-2442
- 14 Yang W. et al. Associations between metformin use and vitamin B12 level, anemia and neuropathy in patients with diabetes: a meta-analysis. J Diabetes 2019; 11: 729-743
- 15 Uncini A. et al. Polyneuropathy associated with duodenal infusion of levodopa in Parkinson's disease: features, pathogenesis and management. J Neurol Neurosurg Psychiatry 2015; 86: 490-495
- 16 Wolffenbuttel BHR. et al. The many faces of cobalamin (vitamin B12) deficiency. Mayo Clin Proc Inn Qual Out 2019; 3: 200-214
- 17 Köbe T. et al. Vitamin B12 concentration, memory performance and hippocampal structure in patients with mild cognitive impairment. Am J Clin Nutr 2016; 103: 1045-1054
- 18 Djukic M. et al. Frequency of dementia syndromes with a potentially treatable cause in geriatric in-patients: analysis of a 1-year interval. Eur Arch Psychiatry Clin Neurosci 2015; 265: 429-438
- 19 Chen H. et al. Associations between Alzheimer's disease and blood homocysteine, vitamin B12 and folate: a case-control study. Curr Alzheimer Res 2015; 12: 88-94
- 20 Tiemeier H. et al. Vitamin B12, folate and homocysteine in depression: the Rotterdam Study. Am J Psychiatry 2002; 159: 2009-2101
- 21 NICE-Guideline 239. Vitamin B12 deficiency in over 16s: diagnosis and management. www.nice.org.uk/guidance/ng239 (Stand: 07.06.2024)
- 22 Andrès E. et al. Systematic review and pragmatic clinical approach to oral and nasal vitamin B12 (Cobalamin) treatment in patients with vitamin B12 deficiency related to gastrointestinal disorders. J Clin Med 2018; 7: 304
- 23 Wang H. et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database of Syst Rev 2018; 3: CD004655
- 24 Zhou J. et al. Associations of vitamin D status with colorectal cancer risk and survival. Int J Cancer 2021; 149: 606-614
- 25 Maalmi H. et al. Serum 25-hydroxyvitamin D levels and survival in colorectal and breast cancer patients: Systematic review and meta-analysis of prospective cohort studies. Eur J Cancer 2014; 50: 1510-1521
- 26 Maalmi H. et al. Association between Blood 25-Hydroxyvitamin D Levels and Survival in Colorectal Cancer Patients: An Updated Systematic Review and Meta-Analysis. Nutrients. 2018; 10: 896
- 27 Pilz S. et al. Role of vitamin D in arterial hypertension. Expert Rev Cardiovasc Ther 2010; 8: 1599-1608
- 28 Martineau AR. et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 15: 356
- 29 Hall SC. et al. Vitamin D and Bronchial Asthma: An Overview of Data from the Past 5 Years. Clin Ther 2017; 39: 917-929
- 30 Dankers W. et al. Vitamin D in autoimmunity: molecular mechanisms and therapeutic potential. Front Immunol 2017; 7: 697
- 31 Manson JE. et al. Principal results of the VITamin D and OmegA-3 TriaL (VITAL) and updated meta-analyses of relevant vitamin D trials. J Steroid Biochem Mol Biol 2020; 198: 105522
- 32 Chandler PD. et al. Effect of Vitamin D3 Supplements on Development of Advanced Cancer: A Secondary Analysis of the VITAL Randomized Clinical Trial. JAMA Netw Open 2020; 3: e2025850
- 33 Pilz S. et al. Critical Appraisal of Large Vitamin D Randomized Controlled Trials. Nutrients 2022; 14: 303
- 34 Sutherland JP. et al. Vitamin D deficiency increases mortality risk in the UK Biobank. Ann Intern Med 2022; 175: 1552-1559 326/M21-3324
- 35 Pludowski P. et al. Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement. Nutrients 2022; 14: 1483
- 36 Gröber U. et al. Magnesium in prevention and therapy. Nutrients 2015; 7: 8199-8226
- 37 Dong JY. et al. Magnesiumaufnahme und Risiko für Typ-2-Diabetes: Metaanalyse prospektiver Kohortenstudien. Diabetes-Pflege 2011; 34: 2116-2122
- 38 Simental-Mendía LE. et al. A systematic review and meta-analysis of randomized controlled trials on the effects of magnesium supplementation on insulin sensitivity and glucose control. Pharmacol Res 2016; 111: 272-282
- 39 Asbaghi O. et al. The effects of oral magnesium supplementation on glycaemic control in patients with type 2 diabetes: a systematic review and dose-response meta-analysis of controlled clinical trials. Br J Nutr 2022; 128: 2363-2372
- 40 Song Y. et al. Dietary magnesium intake and risk of incident hypertension among middle-aged and older US women in a 10-year follow-up study. Am J Cardiol 2006; 98: 1616-1621
- 41 Wannamethee SG. et al. Serum magnesium and risk of incident heart failure in older men: The British Regional Heart Study. Eur J Epidemiol 2018; 33: 873-882
- 42 Kisters K. et al. Ionized magnesium deficiency in elderly hypertensive patients – A pilot study. Nutr Food Sci J 2020; 3: 129-134
- 43 Verma H. et al. Effect of magnesium supplementation on type 2 diabetes associated cardiovascular risk factors: A systematic review and meta-analysis. J Hum Nutr Diet 2017; 30: 621-633
- 44 Zhang X. et al. Effects of magnesium supplementation on blood pressure. A meta-analysis of randomized double-blind placebo-controlled trials. Hypertension 2016; 68: 324-333
- 45 Kisters K. Oral magnesium supplementation improves borderline hypertension. Magnes Res 2011; 24: 17-18
- 46 Kisters K. et al. Low ionized magnesium, vitamin D and interleukin 6 concentration in elderly hypertensive patients. Trace Elem and Elektrolytes 2021; 38: 63-67
- 47 Kisters K. et al. Magnesiumhaushalt und -therapie bei Hypertonie. Nieren- und Hochdruckkrankheiten 2020; 49: 245-251
- 48 Vierling W. et al. Magnesiummangel und Magnesiumtherapie bei Herzrhythmusstörungen. Empfehlungen der Gesellschaft für Magnesium-Forschung e. V. Dtsch Med Wochenschr 2013; 138: 1165-1171
- 49 Viskin S. Torsades de Pointes. Curr Treat Options Cardiovasc Med 1999; 1: 187-195
- 50 Stühlinger HG. Die Bedeutung von Magnesium bei kardiovaskulären Erkrankungen. J Kardiol 2002; 9: 389-395
- 51 Priori SG. et al. 201S ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Europace 2015; 17: 1601-1687
- 52 Nielsen FH. Dietary Magnesium and Chronic Disease. Adv Chronic Kidney Dis 2018; 25: 230-235
- 53 Micke O. et al. Magnesium: Bedeutung für die hausärztliche Praxis – Positionspapier der Gesellschaft für Magnesium-Forschung e. V. Dtsch Med Wochenschr 2020; 145: 1628-1634
- 54 Bundesinstitut für Risikobewertung BfR. Stellungnahme Nr. 034/2017 vom 12. Dezember 2017. Im Internet: https://bfr.bund.de/cm/343/bfr-bewertet-empfohlene-tageshoechstmenge-fuer-die-aufnahme-von-magnesium-ueber-nahrungsergaenzungsmittel.pdf (Stand: 07.06.2024)
- 55 Weißenborn A. et al. Höchstmengen für Vitamine und Mineralstoffe in Nahrungsergänzungsmitteln. J Consum Prot Food Saf 2018; 13: 25-39 DOI: 10.1007/s00003-017-1140-y.