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[125] The ability to absorb vitamin B 12 declines with age, particularly in individuals over 60

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A few commenters emphasized the importance of implementing measures that use validated, flexible, and interdisciplinary tools, such as the Patient-Reported Outcomes Measurement Information System (PROMIS), World Health Organization Well-Being Index (WHO-5), Patient Health Questionnaire-9 ( (PHQ-9), Canadian Occupational Performance Measure (COPM), Occupational Self-Assessment (OSA), and Self-Management Ability Scale (SMAS), that capture individualized outcomes including participation, resilience, and quality of life