Which vitamin deficiency is most likely to occur in an older adult who consumes alcohol regularly?

• A. Vitamin K
• B. Thiamin
• C. Vitamin A
• D. Vitamin D

Answer: (B)

Regular alcohol use in older adults most commonly disrupts thiamine (vitamin B1) status. Alcohol interferes with thiamine in several ways: it lowers dietary intake, impairs absorption in the gut, reduces hepatic storage, and hinders conversion to the active coenzyme thiamine pyrophosphate. Since body stores of thiamine are small and use can rise with alcohol-related malnutrition, deficiency can develop quickly with ongoing alcohol use. The brain is especially sensitive to thiamine loss, so deficiency can manifest as confusion, ataxia, and eye problems, and if not treated, can progress to Wernicke’s encephalopathy and Korsakoff syndrome. Other vitamins can be deficient in various conditions, but the pattern most associated with regular alcohol consumption in an older adult is thiamine deficiency.