THE RESPONSE TO TREATMENT OF SUBCLINICAL THIAMINE-DEFICIENCY IN THE ELDERLY

The significance of subclinical thiamine deficiency in the elderly was determined by assessing response to thiamine supplementation in a ran domized double-blind, placebo-controlled trial. Thirty-five of 222 peo ple aged greater than or equal to 65 y had two concentrations of eryth rocyte thiamine pyrophosphate (TPP) < 140 nmol/L 3 mo apart and 41 oth er people had the first, but not the second, TPP concentration below t his value. Both groups were randomly assigned in a double-blind trial to oral thiamine (10 mg/d) or a placebo. All subjects randomly assigne d to receive thiamine showed increases in TPP concentrations compared with control subjects. Only the subjects with persistently low TPP con centrations showed subjective benefits from treatment with improvement s in quality of life (measured on a visual analogue scale; P = 0.02) a nd decreases in systolic blood pressure (P = 0.05) and weight (P < 0.0 1) when compared with subjects given placebo. There was a trend toward benefits in sleep and energy (P = 0.07). We conclude that a low TPP c oncentration on two occasions is a better predictor of response to tre atment than an isolated measurement. Quality of life was enhanced by p roviding thiamine supplements. Blood pressure and weight were lower af ter thiamine supplementation.