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Low B12 can disrupt this process

Nat Neurosci 8 : 853854

Activating sirtuins through adequate NAD+ levels is associated with improved mitochondrial function, reduced inflammation, and extended cellular lifespan

Better Bone Health: Adequate B12 levels are associated with higher bone mineral density

The additional marginal effect of the 1-star reduction is fairly minimal in the scope of ordinary year-on-year changes and is likely less than the one-time impact of other significant methodological changes in past years (most significantly the switch from latent variable modeling to explicit average measure group scoring and the introduction of peer grouping) (85 FR 86193)