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In older people, a B12 deficiency usually happens as a result of insufficient levels of either stomach acid or intrinsic factor that limit absorption

[6] If this happens, vitamin B 12 deficiency may result in sense loss, loss of sensation in the feet, difficulty walking, poor balance, blurred vision, changes in reflexes, muscle weakness, decreased smell and taste, decreased level of consciousness, mood changes, memory loss, depression, irritability, clumsiness, disorientation, dementia and, in severe cases, psychosis

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5.5 Interference with Diagnosis of Megaloblastic Anemia M.V.I

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However, the Academy of Nutrition and Dietetics considers plant and algae sources "unreliable", stating that vegans should turn to fortified foods and supplements instead