Vital Signs: B12 and Dementia

Why was my patient suddenly falling apart after decades of healthy living?

By Lesley Evans Ogden
Feb 1, 2000 6:00 AMMay 9, 2023 4:19 PM

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Although I had known Pop Katz and his family for a long time, I had not seen him in years. Now I scarcely recognized him. He was standing in my office-just barely. If his grandson hadn't been holding him up, he'd have pitched straight forward onto his face. Saliva dribbled from the corners of his mouth. His eyes were vacant.

The two had just flown in from Miami to see me. Pop's wife said she couldn't take care of him anymore, but she didn't want him to end up in a nursing home. So she asked their grandson, a psychologist, to bring the octogenarian to me for an evaluation.

Together we reviewed the history. A month ago, the grandson had visited his grandparents and as usual, Pop took him on a three-mile run, joking all the while about how his strict vegetarian habits helped him outperform his juniors. A week or so later, Pop's wife was troubled. "He cries so easily," she told her grandson. The grandson had advised a visit to their doctor, even though he knew Pop liked doctors about as much as rare steak. His wife managed to get him there anyway, and after a cursory exam and blood count, he went away with a clean bill of health.

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