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Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit, selected frailty biomarkers (interleukin-6, tumor necrosis factor-alpha, and insulin-like growth factor-1), physical function, cognitive function, nutritional status and biochemical profile

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Additionally, Metformin may alter gut bacteria, potentially leading to intestinal bacterial overgrowth that further hinders B12 uptake

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