How Many Published Clinical Case Reports Explicitly Record Falls Concurrently With Signs of Vitamin B12 Deficiency? A Literature Review of Clinical Case Reports Published Between 2006 – 2017
By Kim Adams - Nutrition Science and Practice
Abstract
Background
Vitamin B12 (VB12) deficiency and falls share common risk factors but there is little research on any potential relationship. Published clinical case reports suggest an association. However, these have not previously been collated to understand the extent to which this relationship is recorded as a feature of VB12 deficiency.
Aim
To identify the number of clinical case reports which explicitly recorded falls concurrently with signs of VB12 deficiency.
Methodology
A review of case reports of VB12 deficiency published between 2006 and 2017 was undertaken. Electronic databases were searched to identify reports. Inclusion and exclusion criteria were developed to inform search strategy and sift results. Joanna Briggs Institute critical appraisal tool for case reports was used to critically analyse quality. Papers meeting quality criteria were reviewed. Instances where falls or fall risk factors were explicitly reported with signs and symptoms of VB12 deficiency were documented. Key characteristics, including haematological, psychiatric and neurological signs of VB12 deficiency, were collated and synthesised for analysis. Timeline analysis was performed on cases detailing falls. Signs and symptoms were mapped pre-diagnosis, during and post treatment.
Findings
Of 240 cases appropriate for review, 76 met quality criteria. Falls were explicitly recorded in six cases. A further 52 recorded one or more signs of VB12 deficiency considered as fall risk factors. Timeline analysis illustrated onset of falls concurrently with presentation of VB12 deficiency. Symptoms were resolved following VB12 treatment. Inconsistencies in quality of case reporting prevented further synthesis of findings.
Conclusion
- Falls are a feature explicitly recorded alongside signs and symptoms of VB12 deficiency in some cases.
- Detailed analysis of individual cases suggests falls related to signs and symptoms of VB12 deficiency and ceased following successful treatment.
- Quality of reporting precluded further analysis.
- It is recommended authors adhere to CARE guidelines to improve case report quality.
