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It is especially common in older individuals, occurring in more than 20% of the elderly population (Vitamin B12 (cobalamin) deficiency in elderly patients)
Grade II includes partial ligament tearing with moderate swelling, bruising, and some joint laxity
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The American Academy of Family Physicians and NIH identify the following clinical manifestations: Fatigue and generalized weakness Megaloblastic anemia (abnormally large, immature red blood cells) Tingling or numbness in the hands and feet (peripheral neuropathy) Difficulty walking and balance problems Cognitive disturbances including memory difficulty and confusion Mood changes, including depression and irritability Glossitis (swollen, inflamed tongue) Early symptoms such as fatigue and mild tingling are often attributed to stress, aging, or other conditions
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