An alarming number of older adults are walking around with low levels of super-important vitamins. Experts explain why—and how to make sure you're hitting healthy levels.
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If you’re 65 or older and feeling a bit off, it could be because you’re running low on key vitamins for seniors—specifically, vitamins D and B12. In a study published in Nutrients, researchers explored how genetics, lifestyle, and environmental factors affect healthy aging. When they reviewed 1,000 blood samples taken from participants ages 65 to 93, they found that more than half were not getting enough vitamin D, and one in four had a vitamin B12 deficiency.
Further research reinforces just how common these nutrient shortfalls are as we age—and the health risks they pose. A 2023 study published in Frontiers in Nutrition reported that more than half of U.S. adults over age 50 are vitamin D deficient or insufficient, noting that low levels are linked with increased risk of chronic diseases such as heart disease, diabetes, cancer, and brain disorders.
In addition, 2025 research published in Brain Disorders highlights that vitamin B12 deficiency remains widespread among older adults, warning that low levels are associated with cognitive issues and nerve-related problems.
Yet across these studies, researchers weren’t entirely surprised. They explain that aging brings natural changes that can make it harder for the body to absorb, convert, and store certain nutrients. As a result, older adults are more likely to develop certain micronutrient deficiencies without making key dietary tweaks.
The body makes vitamin D when sunlight hits your skin. According to 2023 research published in Photochemistry and Photobiology, most people need about five to 10 minutes of sun exposure for adequate vitamin D production—though if you live somewhere wintery, that can increase to up to 45 minutes of midday sunlight.
However, “Older adults are prone to a vitamin D deficiency due to changes in their skin’s ability to convert this vitamin into the active form used by the body,” says Steven Starks, MD, MBA, DFAPA, a board-certified geriatric psychiatrist and medical educator. To shore up any gaps, fatty fish, eggs, and fortified cereals and juices are good dietary sources of vitamin D.
Vitamin B12 absorption also declines with age. “Seniors are more likely to develop a vitamin B12 deficiency because their stomachs produce less acid,” Dr. Starks explains. “It’s the acidity that helps our bodies absorb this vitamin.” Among the foods naturally high in vitamin B12: salmon, liver, clams, and dairy products.
Vitamin D and B12 are crucial vitamins for healthy aging. Low levels of vitamin D can lead to health problems, including bone and muscle pain, high blood pressure, and depression. A B12 deficiency can cause tiredness, weakness, constipation, loss of appetite, weight loss, and anemia.
“Doctors will typically check your levels if there’s an identifiable change in your health,” says Dr. Starks.
He says to ask your doctor about checking your vitamin D levels if you’re experiencing:
And ask about your vitamin B12 levels if you have:
If you’re deficient, your doctor may recommend you take these vitamins as a dietary supplement to get your levels back in check.
Poststroke spasticity (PSS) is a common sensorimotor disorder following a stroke, presenting in up to 38% of patients 1 year after first stroke. Owing to its heterogeneous and progressive presentation, PSS represents a significant challenge both in its effect on patients and in its clinical management. The objective of this US real-world survey was to assess the impact of self-reported PSS symptoms, gathering patient and caregiver perspectives on awareness of PSS and its treatments, the extent of shared decision-making, and the quality of life (QoL) impact of PSS.
Methods:
This study was a noninterventional, cross-sectional, web-based survey of patients (or their caregivers) within 1 year of stroke resulting in hemiparesis. Participant demographics and survey responses were summarized using descriptive analyses. Subgroup analyses were performed between patients and caregivers and by sex, age group, and type of last stroke. A short version of the Stroke-Specific QoL (SS-QoL) scale was used to assess patient QoL.
Results:
The study included 221 patients and 62 caregivers answering on behalf of patients. Almost all patients (98%) experienced PSS symptoms after their most recent stroke, with 59% experiencing ≥3 symptoms. Approximately half (56%) of patients who reported PSS symptoms were aware of drug treatments; of these, most (95%) had received ≥1 drug treatment. Among treated patients, 68% had been involved in the initial drug selection. Over half of patients reported difficulties carrying out daily activities, but caregivers were more likely to report difficulty showering or bathing unassisted (84%) compared with the patient group (58%); fatigue was reported by most patients (84%). The overall median (IQR) SS-QoL score was 2.5 (2.0–2.9) and was higher in the patient group (2.5; 2.1–2.9) than the caregiver-reported group (2.1; 1.8–2.8). Our real-world survey findings demonstrate a considerable impact of PSS on patient QoL, largely driven by fatigue and limitations in daily activities. Furthermore, subgroup analysis revealed significant differences between patient and caregiver perceptions of PSS symptoms and their impact.
Discussion:
This study highlights the need for increased awareness of PSS among healthcare providers, patients, and caregivers to promote timely diagnosis and improve management with targeted, multidisciplinary interventions that enhance patient outcomes and support caregivers.
After a stroke, some people experience a condition called poststroke spasticity (PSS) that causes muscle stiffness and uncontrolled spasms. Symptoms are not the same for everyone with PSS and may get worse over time. This survey-based study described how people with PSS and their caregivers were affected by PSS after a stroke. The survey included questions related to a person’s knowledge about the condition, access to treatments, and how PSS impacts their daily life. The researchers also looked at differences in people’s responses based on their age, sex, and the type of stroke they experienced, as well as whether the patient or their caregiver completed the survey. Nearly all of the people who took the survey experienced PSS symptoms after their most recent stroke, but only half of them were receiving drug treatment for their PSS symptoms. People most often reported being affected by fatigue and difficulty in doing daily activities, such as showering or bathing. Also, caregivers reported a greater impact on quality of life than patients themselves. This study emphasized the need for education about PSS to improve diagnosis, management, and support for patients and their caregivers.
Post-stroke spasticity (PSS) is a heterogeneous complication of stroke that affects motor recovery, care needs, pain, positioning, and participation in daily life. Current management frameworks commonly stratify patients by time since stroke, but disease duration alone does not capture differences in neural mechanisms, residual voluntary control, functional priorities, or response to intervention. This narrative review searched PubMed, the Cochrane Library, and Wanfang databases from inception to May 2026, prioritizing randomized controlled trials, prospective cohort studies, systematic reviews, real-world studies, Goal Attainment Scaling research, the Upper Limb International Spasticity cohort series, best-practice guidance, and clinical trials including BEST and InTENSE. We synthesize evidence that PSS heterogeneity can be understood across central and peripheral mechanisms, temporal trajectories, and active versus passive functional consequences. Available studies suggest that active and passive functional goals differ in baseline functional profiles, outcome assessment, treatment response, and intervention requirements. However, patients sharing a functional goal type may still differ in residual voluntary control, neural and non-neural contributors to movement restriction, pain, mobility, and care dependency. Botulinum toxin type A is well aligned with focal tone reduction and passive goals, including pain relief, hygiene, and limb positioning. It may also support contracture-prevention strategies when modifiable neural muscle overactivity remains, whereas active functional gains usually require preserved motor potential and integration with task-oriented training, rehabilitation, and adjunctive modalities. We propose that functional goal type should complement time-based staging as a decision dimension rather than serve as a complete clinical phenotype. This combined framework may better align patient selection, intervention matching, outcome assessment, and longitudinal treatment planning. Prospective goal-stratified studies and standardized assessment tools are needed to test its clinical utility.
To evaluate the effects of adjunctive hyperbaric oxygen therapy (HBOT) on cognitive, neurological, and functional outcomes in patients with post-stroke cognitive impairment (PSCI), and explore potential sources of heterogeneity.
Methods:
Eight databases were searched from inception to July 15, 2026. Randomized controlled trials (RCTs) evaluating adjunctive HBOT in patients with PSCI were included. The primary outcome was the Montreal Cognitive Assessment (MoCA); secondary outcomes included the Mini-Mental State Examination (MMSE), National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI), and Barthel Index (BI). Random-effects meta-analyses, prespecified subgroup analyses, and meta-regression were performed. Sensitivity analyses, funnel plots, Egger’s tests, and GRADE assessments were conducted.
Results:
Thirty-five RCTs involving 3,036 participants, all conducted in China, were included. Adjunctive HBOT was associated with higher MoCA scores (MD = 2.90, 95% CI: 2.47–3.33; p < 0.00001; I2 = 84%) and MMSE scores (MD = 2.68, 95% CI: 2.20–3.16; p < 0.00001; I2 = 83%). Improvements were also observed in NIHSS (MD = −2.61, 95% CI: −3.34 to −1.89; p < 0.00001; I2 = 93%), MBI (MD = 6.64, 95% CI: 3.76–9.52; p < 0.00001; I2 = 82%), and BI (MD = 8.77, 95% CI: 4.72–12.82;p < 0.00001; I2 = 82%). No statistically significant subgroup differences were observed for MoCA (p = 0.10) or MMSE (p = 0.43). Higher baseline MoCA scores tended to be associated with smaller treatment effects in meta-regression (β = −0.1411, p = 0.0637; R2 = 15.42%). Substantial heterogeneity remained largely unexplained. Evidence certainty was low for MoCA, MMSE, and MBI and very low for NIHSS and BI.
Conclusion:
Adjunctive HBOT may(NOT GOOD ENOUGH!) provide cognitive and functional benefits in patients with PSCI. However, substantial unexplained heterogeneity, low-to-very-low certainty of evidence, and the exclusively Chinese evidence base warrant cautious interpretation and limit generalizability. Further well-designed RCTs involving diverse populations are needed.
Systematic review registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420261473579, PROSPERO, CRD420261473579.
