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routine B12 level monitoring is generally unnecessary once replacement is established, as levels do not reliably correlate with tissue stores Important safety considerations: Older adults may have impaired renal function, though this rarely affects B12 therapy given its wide safety margin

664 Over half of dementia caregivers experience financial toxicity (i.e., the negative effects of medical expenses on financial security and healthrelated quality of life)

Sublingual or lozenge forms: These bypass the gut and are absorbed directly into the bloodstream, ideal for those with digestive or absorption challenges

Control rats with the ligated superior mesenteric vein and artery regularly showed a poor presentation (Figure 5), and they responded with rapid rupture of the superior mesenteric vein or without a sign of the superior mesenteric artery

Signs of dehydration, fainting, confusion, or inability to keep fluids down should not wait for routine labs