Nutritional deficiency does not fit the view of life in an affluent society and in fact typical diseases resulting from a deficiency of vitamins are actually a rarity. On the other hand, elderly people must be regarded as an essential risk group for vitamin deficiency because of various influence factors. The frequency of lowered vitamin concentrations in the blood increases with age. However, knowledge on the consequences for this population is insufficient, especially for hyperhomocysteinemia. Investigations have yielded the following results: 1. Hyperhomocysteinemia often occurs with advanced age; 2. Impairment of physical condition or social situation seems to increase the risk of hyperhomocysteinemia; 3. Administration of the vitamins B6, B12 and folate causes a significant decrease of elevated serum homocysteine concentrations in older persons. Homocysteine-lowering treatment should improve the prevention of chronic diseases. The question is which effects can be expected from such treatment in the elderly. Because of its great importance for both the persons concerned and society in general hyperhomocysteinemia in advanced age requires further systematic examination.