To the Editor.
—The article on gastric acidity in older adults by Dr Hurwitz and colleagues1 is of great interest. It is well known that hypochlorhydria does not often result in the colonization of the upper gastrointestinal tract with bacterial pathogens.2 However, hypochlorhydria due to atrophic gastritis can result in malabsorption of food-bound vitamin B12, and this continues to be a public health concern.3,4We studied the prevalence of atrophic gastritis in a white elderly population approximately 12 years ago and found the overall prevalence of atrophic gastritis in those older than 60 years to be approximately 30%.5 This contrasts with the 9% prevalence of atrophic gastritis in the Midwest population in the present study using the same criterion for diagnosis.1 Unlike the study by Hurwitz et al, our study found the prevalence of atrophic gastritis to increase with advancing age. In Boston, Mass
Russell RM. Gastric Hypochlorhydria and Achlorhydria in Older Adults. JAMA. 1997;278(20):1659. doi:10.1001/jama.1997.03550200035022