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A decrease in the levels of both vitamins can contribute to cognitive decline in older populations [65]

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PMID 8856015

Future research should prioritise long-term outcomes in high-risk groups, comparisons of physiological versus pharmacological dosages in healthy subjects, cost-effectiveness analyses, and adherence monitoring to inform clinical guidelines for the management and prevention of B12 deficiency

An assumption of parametric analyses that was not tested by the tool was a lack of outliers