Lack of Seasonal Variations in Vitamin D Concentrations among Hospitalized Elderly Patients

Background. Generally, most vitamin D in the human body (90–95%) is produced in the skin during exposure to sunlight. The effectiveness of this process depends on several biological and physical factors, e.g., age or latitude. Skin synthesis of vitamin D among elderly people is reduced. The aim of the study was to assess serum 25-hydroxyvitamin D [25(OH)D] seasonal variations in elderly patients hospitalized at the geriatric department. Methods. The study was carried out on 242 patients aged 60 years or older hospitalized at the geriatric department. The study group was categorized by four seasons as well as month. Results. The median (interquartile range) 25(OH)D concentration among all patients (n = 242) was 33.95 (26.96–45.18) nmol/L. There was no statistical significance in the median serum 25(OH)D concentration with regard to each of the four seasons: in the spring 32.95 (25.96–43.68) nmol/L, in the summer 38.69 (27.46–50.67) nmol/L, in the autumn 33.45 (27.08–44.18) nmol/L, in the winter 34.57 (23.46–43.93) nmol/L, (p = 0.48). Conclusions. Vitamin D deficiency was observed in all geriatric patients, irrespective of the season. The results of the study indicate no significant differences in median vitamin D concentration among the hospitalized patients across all four seasons. Even in the summer months, in our climate, it is fairly difficult for an elderly person to produce an adequate amount of vitamin D through the skin. Therefore, proper vitamin D supplementation is recommended and should be implemented in the elderly irrespective of the season.

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Effects of vitamin D supplementation on 25(OH)D levels and blood pressure in the elderly: a systematic review and meta-analysis

F1000Research ◽

10.12688/f1000research.24623.2 ◽

2020 ◽

Vol 9 ◽

pp. 633

Author(s):

Farapti Farapti ◽

Chusnul Fadilla ◽

Niwanda Yogiswara ◽

Merryana Adriani

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

The Elderly ◽

Vitamin D Supplementation ◽

Control Groups ◽

Elderly Age ◽

Hydroxyvitamin D ◽

And Control

Background: Hypertension and vitamin D deficiency are prevalent among the elderly. This study evaluated the effects of vitamin D supplementation on changes in serum 25-hydroxyvitamin D (25(OH)D) levels and blood pressure (BP) in the elderly (age > 60 years). Methods: Randomized controlled trials from electronic databases on the elderly taking oral vitamin D, until the end of March 2019, were selected. Two reviewers independently screened the literature on the basis of specific inclusion criteria. The primary outcomes were serum 25(OH)D level, systolic BP (SBP), and diastolic BP (DBP) changes. Results: Our analysis revealed significant differences in serum 25(OH)D level changes between the vitamin D and control groups (mean difference [MD] = 13.84; 95% confidence interval [CI] = 10.21–17.47; P < 0.000). There were no significant differences in SBP and DBP changes between the vitamin D and control groups. Subgroup analysis revealed significant differences in SBP changes between the hypertensive and vitamin D-deficient subgroups (MD = –4.01; 95% CI = –7.45 to –0.57; P = 0.02 and MD = –1.91; 95% CI = –3.48 to –0.34; P = 0.02, respectively), and DBP changes only in the hypertensive subgroup (MD = –2.22; 95% CI = –4.1 to –0.34; P = 0.02). Conclusions: Vitamin D supplementation significantly increases 25(OH)D levels and seems beneficial in lowering BP, specifically in the elderly with elevated BP and vitamin D deficiency.

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Vitamin D deficiency in elderly people in Swedish nursing homes is associated with increased mortality

Acta Endocrinologica ◽

10.1530/eje-13-0855 ◽

2014 ◽

Vol 170 (5) ◽

pp. 667-675 ◽

Cited By ~ 25

Author(s):

Maria Samefors ◽

Carl Johan Östgren ◽

Sigvard Mölstad ◽

Christina Lannering ◽

Patrik Midlöv ◽

...

Keyword(s):

Vitamin D ◽

Nursing Homes ◽

Vitamin D Deficiency ◽

Elderly People ◽

The Elderly ◽

Vitamin D Supplementation ◽

Hydroxyvitamin D ◽

Northern Latitudes ◽

Hazard Ratios ◽

Vitamin D Levels

ObjectiveInstitutionalised elderly people at northern latitudes may be at elevated risk for vitamin D deficiency. In addition to osteoporosis-related disorders, vitamin D deficiency may influence several medical conditions conferring an increased mortality risk. The aim of this study was to explore the prevalence of vitamin D deficiency and its association with mortality.DesignThe Study of Health and Drugs in the Elderly (SHADES) is a prospective cohort study among elderly people (>65 years) in 11 nursing homes in Sweden.MethodsWe analysed the levels of 25-hydroxyvitamin D3(25(OH)D3) at baseline. Vital status of the subjects was ascertained and hazard ratios (HRs) for mortality according to 25(OH)D3quartiles were calculated.ResultsWe examined 333 study participants with a mean follow-up of 3 years. A total of 147 (44%) patients died within this period. Compared with the subjects in Q4 (25(OH)D3>48 nmol/l), HR (with 95% CI) for mortality was 2.02 (1.31–3.12) in Q1 (25(OH)D3<29 nmol/l) (P<0.05); 2.03 (1.32–3.14) in Q2 (25(OH)D330–37 nmol/l) (P<0.05) and 1.6 (1.03–2.48) in Q3 (25(OH)D338–47 nmol/l) (P<0.05). The mean 25(OH)D3concentration was 40.2 nmol/l (s.d. 16.0) and 80% had 25(OH)D3below 50 nmol/l. The vitamin D levels decreased from baseline to the second and third measurements.ConclusionsVitamin D deficiency was highly prevalent and associated with increased mortality among the elderly in Swedish nursing homes. Strategies are needed to prevent, and maybe treat, vitamin D deficiency in the elderly in nursing homes and the benefit of vitamin D supplementation should be evaluated in randomised clinical trials.

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Effects of vitamin D supplementation on 25(OH)D levels and blood pressure in the elderly: a systematic review and meta-analysis

F1000Research ◽

10.12688/f1000research.24623.1 ◽

2020 ◽

Vol 9 ◽

pp. 633

Author(s):

Farapti Farapti ◽

Chusnul Fadilla ◽

Niwanda Yogiswara

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

The Elderly ◽

Vitamin D Supplementation ◽

Control Groups ◽

Elderly Age ◽

Hydroxyvitamin D ◽

And Control

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The ADeViD Study: Alzheimer’s Dementia and Vitamin D Study

Neurology and Neurobiology ◽

10.31487/j.nnb.2020.02.07 ◽

2020 ◽

pp. 1-4

Author(s):

Alberto Castagna ◽

Carmen Ruberto ◽

Giovanni Ruotolo ◽

Giuseppe Attisani ◽

...

Keyword(s):

Vitamin D ◽

Elderly Patients ◽

Cognitive Functions ◽

Cognitive Disorders ◽

Hypovitaminosis D ◽

Serum Levels ◽

The Elderly ◽

Cognitive Status ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Introduction: Aging is associated with a large increase in the prevalence of hypovitaminosis D. 25- Hydroxyvitamin D, 25(OH)D, is the best indicator for vitamin D status. Its possible role in the pathogenesis of Alzheimer’s disease (AD), the leading cause of dementia in the elderly, is particularly important. The aim of the present study was to examine the association between 25-hydroxyvitamin D (25(OH)D) and cognitive functions in a group of Italian elderly patients affected with AD. Methods: We studied the relationship between 25(OH)D and cognitive functions assessed by MMSE (Mini Mental State Examination) in 150 consecutive elderly patients (F 76 %, age 78,66+ 6,05 years old) attending our Geriatric ambulatory for cognitive disorders with diagnosis of AD. Results: In our sample hypovitaminosis D was present in 100% of the screened patients; 111 patients (74%) had 25(OH)D serum levels inferior to 20 ng/ml; 39 (26%) patients had serum levels included between 20 and 30 ng/ml. After adjustment for age, gender, systolic blood pressure, education, cardiovascular diseases and antihypertensive treatment, a significant relationship was observed between 25(OH)D and cognitive status. MMSE appeared significantly higher in subjects with 25(OH)D serum levels ≥ 20 ng/ml than in those with 25(OH)D < 20 ng/ml (18,42+4,33 vs 12,22+4,44; p=0,000). Conclusion: Our results showed a relationship between 25(OH)D and cognitive impairment in patients with AD, suggesting that 25(OH)D could be involved in the onset of dementia.

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Effects of vitamin D supplementation on 25(OH)D concentrations and blood pressure in the elderly: a systematic review and meta-analysis

F1000Research ◽

10.12688/f1000research.24623.3 ◽

2020 ◽

Vol 9 ◽

pp. 633

Author(s):

Farapti Farapti ◽

Chusnul Fadilla ◽

Niwanda Yogiswara ◽

Merryana Adriani

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

The Elderly ◽

Vitamin D Supplementation ◽

Control Groups ◽

Elderly Age ◽

Hydroxyvitamin D ◽

And Control

Background: Hypertension and vitamin D deficiency are prevalent among the elderly. This study evaluated the effects of vitamin D supplementation on changes in serum 25-hydroxyvitamin D (25(OH)D) concentrations and blood pressure (BP) in the elderly (age > 60 years). Methods: Randomized controlled trials from electronic databases on the elderly taking oral vitamin D, until the end of March 2019, were selected. Two reviewers independently screened the literature on the basis of specific inclusion criteria. The primary outcomes were serum 25(OH)D level, systolic BP (SBP), and diastolic BP (DBP) changes. Results: Our analysis revealed significant differences in serum 25(OH)D concentrations changes between the vitamin D and control groups (mean difference [MD] = 13.84; 95% confidence interval [CI] = 10.21–17.47; P < 0.000). There were no significant differences in SBP and DBP changes between the vitamin D and control groups. Subgroup analysis revealed significant differences in SBP changes between the hypertensive and vitamin D-deficient subgroups (MD = –4.01; 95% CI = –7.45 to –0.57; P = 0.02 and MD = –1.91; 95% CI = –3.48 to –0.34; P = 0.02, respectively), and DBP changes only in the hypertensive subgroup (MD = –2.22; 95% CI = –4.1 to –0.34; P = 0.02). Conclusions: Vitamin D supplementation significantly increases 25(OH)D concentrations and seems beneficial in lowering BP, specifically in the elderly with elevated BP and vitamin D deficiency.

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Profiling older community-dwellers with hypovitaminosis D: A classification tree analysis

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000591 ◽

2020 ◽

Vol 90 (3-4) ◽

pp. 195-199 ◽

Cited By ~ 2

Author(s):

Gaelle Chevallereau ◽

Mathilde Legeay ◽

Guillaume T. Duval ◽

Spyridon N. Karras ◽

Bruno Fantino ◽

...

Keyword(s):

Vitamin D ◽

Classification Tree ◽

Hypovitaminosis D ◽

Vitamin D Supplementation ◽

Community Dwelling ◽

Gait Disorders ◽

Hydroxyvitamin D ◽

Chaid Analysis ◽

Clinical Profiles ◽

Community Dwellers

Abstract. Despite the high prevalence of hypovitaminosis D in older adults, universal vitamin D supplementation is not recommended due to potential risk of intoxication. Our aim here was to determine the clinical profiles of older community-dwellers with hypovitaminosis D. The perspective is to build novel strategies to screen for and supplement those with hypovitaminosis D. A classification tree (CHAID analysis) was performed on multiple datasets standardizedly collected from 1991 older French community-dwelling volunteers ≥ 65 years in 2009–2012. Hypovitaminosis D was defined as serum 25-hydroxyvitamin D ≤ 50 nmol/L. CHAID analysis retained 5 clinical profiles of older community-dwellers with different risks of hypovitaminosis D up to 87.3%, based on various combinations of the following characteristics: polymorbidity, obesity, sadness and gait disorders. For instance, the probability of hypovitaminosis D was 1.42-fold higher [95CI: 1.27–1.59] for those with polymorbidity and gait disorders compared to those with no polymorbidity, no obesity and no sadness. In conclusion, these easily-recordable measures may be used in clinical routine to identify older community-dwellers for whom vitamin D supplementation should be initiated.

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Vitamin D Level Stability in Dystrophinopathy Patients on Vitamin D Supplementation

Journal of Neuromuscular Diseases ◽

10.3233/jnd-200625 ◽

2021 ◽

pp. 1-7

Author(s):

Naomi Vather-Wu ◽

Matthew D. Krasowski ◽

Katherine D. Mathews ◽

Amal Shibli-Rahhal

Keyword(s):

Vitamin D ◽

Retrospective Cohort ◽

Vitamin D Supplementation ◽

Hydroxyvitamin D ◽

Frequent Monitoring ◽

25 Hydroxyvitamin D ◽

The Mean ◽

Stable Maintenance ◽

Mean Time

Background: Expert guidelines recommend annual monitoring of 25-hydroxyvitamin D (25-OHD) and maintaining 25-OHD ≥30 ng/ml in patients with dystrophinopathies. Objective: We hypothesized that 25-OHD remains stable and requires less frequent monitoring in patients taking stable maintenance doses of vitamin D. Methods: We performed a retrospective cohort study, using the electronic health record to identify 26 patients with dystrophinopathies with a baseline 25-OHD ≥30 ng/mL and at least one additional 25-OHD measurement. These patients had received a stable dose of vitamin D for ≥3 months prior to their baseline 25-OHD measurement and throughout follow-up. The main outcome measured was the mean duration time the subjects spent with a 25-OHD ≥30 ng/mL. Results: Only 19% of patients dropped their 25-OHD to < 30 ng/ml, with a mean time to drop of 33 months and a median nadir 25-OHD of 28 ng/mL. Conclusions: These results suggest that measurement of 25-OHD every 2–2.5 years may be sufficient in patients with a baseline 25-OHD ≥30 ng/mL and who are on a stable maintenance dose of vitamin D. Other patients may require more frequent assessments.

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Vitamin D Knowledge, Attitudes and Practices of Polish Medical Doctors

Nutrients ◽

10.3390/nu13072443 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2443

Author(s):

Wojciech Stefan Zgliczyński ◽

Olga Maria Rostkowska ◽

Beata Sarecka-Hujar

Keyword(s):

Vitamin D ◽

Knowledge Score ◽

Vitamin D Supplementation ◽

Medical Doctors ◽

Self Administration ◽

Hydroxyvitamin D ◽

Attitudes And Practices ◽

Study Results ◽

25 Hydroxyvitamin D ◽

Knowledge Attitudes And Practices

Background Vitamin D deficiency occurs in as much as 90–95% of the Polish population, although this condition is known to cause negative long-term health implications. The role of medical doctors in advising proper supplementation, monitoring and correcting the levels of 25-hydroxyvitamin D in individuals is of great importance and should be used to help mitigate its common deficits. The aim of this study was to evaluate knowledge, attitudes and practices of Polish physicians regarding vitamin D supplementation in order to identify areas for improvement and determinants for the knowledge gaps. Methods The study group comprised 701 medical doctors aged 32.1 ± 5.3 years on average, mostly women (71.61%). An original survey questionnaire was developed for the purpose of the study. Results The mean vitamin D knowledge score was 6.8 ± 2.3 (in a scale 0–13) and was related to gender (p < 0.001), type of specialization (p = 0.032), D3 supplements use (p < 0.001), recommending supplementation to patients (p = 0.005), to relatives and friends (p < 0.001) and to healthy adults (p < 0.001). In terms of self-administration, 14% of respondents take vitamin D all-year-round while 24% only in autumn and winter. 25% of respondents monitor their vitamin D (25-hydroxyvitamin D) serum concentration. Most participants (61%) did not recommend supplementing vitamin D to their patients on a regular basis. Conclusions The study indicates that medical doctors in Poland need to have more training and education on vitamin D supplementation in order to better address the problem of its deficits in the population.

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Effects of Vitamin D Supplementation on Surrogate Markers of Fertility in PCOS Women: A Randomized Controlled Trial

Nutrients ◽

10.3390/nu13020547 ◽

2021 ◽

Vol 13 (2) ◽

pp. 547

Author(s):

Elisabeth Lerchbaum ◽

Verena Theiler-Schwetz ◽

Martina Kollmann ◽

Monika Wölfler ◽

Stefan Pilz ◽

...

Keyword(s):

Vitamin D ◽

Treatment Effect ◽

Polycystic Ovary ◽

Controlled Trial ◽

Dehydroepiandrosterone Sulfate ◽

Vitamin D Supplementation ◽

Double Blind ◽

Significant Treatment ◽

Hydroxyvitamin D ◽

Randomized Controlled

Vitamin D (VD) might play an important role in polycystic ovary syndrome (PCOS) and female fertility. However, evidence from randomized controlled trials (RCT) is sparse. We examined VD effects on anti-Müllerian hormone (AMH) and other endocrine markers in PCOS and non-PCOS women. This is a post hoc analysis of a single-center, double-blind RCT conducted between December 2011 and October 2017 at the endocrine outpatient clinic at the Medical University of Graz, Austria. We included 180 PCOS women and 150 non-PCOS women with serum 25-hydroxyvitamin D (25(OH)D) concentrations <75 nmol/L in the trial. We randomized subjects to receive 20,000 IU of VD3/week (119 PCOS, 99 non-PCOS women) or placebo (61 PCOS, 51 non-PCOS women) for 24 weeks. Outcome measures were AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, dehydroepiandrosterone sulfate, and androstenedione. In PCOS women, we observed a significant treatment effect on FSH (mean treatment effect 0.94, 95% confidence interval [CI] 0.087 to 1.799, p = 0.031) and LH/FSH ratio (mean treatment effect −0.335, 95% CI −0.621 to 0.050, p = 0.022), whereas no significant effect was observed in non-PCOS women. In PCOS women, VD treatment for 24 weeks had a significant effect on FSH and LH/FSH ratio but no effect on AMH levels.

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