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Conclusion Whilst severe B12 deficiency has a clear clinical picture with characteristic haematological and/or neurological features, establishing mild or borderline deficiency can be problematic as serum levels are maintained at the expense of tissue concentrations, and therefore serum levels of B12 may be in the low normal or borderline range despite a deficiency

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The risk increases with age, especially for adults over 60, as the bodys ability to absorb B12 naturally declines

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Therefore, optimizing patient outcomes involves understanding and targeting the specific symptom domains that significantly affect individual functioning

Data Analysis Data were analyzed using SPSS 21