Gastric Hypochlorhydria and Achlorhydria in Older Adults

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