IDENTIFICATION OF IRON, FOLATE AND VITAMI N-B12 DEFICIENCIES BY CLINICAL-EVALUATION OF NUTRITION

The clinical examination's ability to detect micronutrients deficienci es has been assessed in 79 patients (average age 75), most of them bei ng at risk of protein-energy malnutrition (N = 66). Clinical signs of iron, folic acid and vitamin Bit deficiencies were searched and relate d to biochemical criteria of nutritional status. The clinical examinat ion allowed to point 8 out of 15 cases of iron deficiency or chronic d iseases anemia (53%), 3 out of 6 cases of folic acid deficiency and 24 out of 36 cases of anemia from all causes (67%). The best predictive clinical signs of iron deficiency and chronic diseases anemia were dys phagia and asthenia, while irritability/depression end loss of pain se nsitivity predicted folic acid deficiency. Anemia from all causes was- predicted by pallor, amnesia, told hypersensitivity, icterus and loss of vibration sense. The clinical models of deficiency generated by the logistic regression analysis showed high predictive values, 72 end 75 % respectively for iron deficiency anemia end anemia from all louses a nd 95% for folic acid deficiency. The clinical examination centered on some ten specific predictive signs and symptoms tan improve the scree ning for iron end folic acid deficiencies in malnourished patients.