Once-weekly dose of 8400 IU vitamin D3 compared with placebo: effects on neuromuscular function and tolerability in older adults with vitamin D insufficiency

Background: Vitamin D deficiency is ubiquitous in frailty but the effectiveness of vitamin D supplementation to improve outcomes in frail individuals is unclear. It has been postulated that higher than the current recommended doses (800 IU/day) may be needed to achieve a neuromuscular effect in frail individuals. Objectives: 1) determine if 4000 IU per day of vitamin D3 is safe for frail older adults; and 2) establish the efficacy of this dose to improve physical performance outcomes in this population. Design: Open-label, feasibility study. Setting: Community retirement centre. Participants: 40 older adults with frail or pre-frail characteristics. Intervention: 4000 IU of vitamin D3 and 1200 mcg of calcium carbonate daily for four months. Measurements: Physical performance (grip strength, gait speed and short physical performance battery score), cognitive health and vitamin D and iPTH serum levels before and after the intervention. Results: Frail individuals improved short physical performance battery score (1.19, p = 0.005), fast gait speed (4.65, p = 0.066) and vitamin D levels (7.81, p = 0.011). Only frail females made a significant improvement in grip strength (1.92, p = 0.003). Stratifying the sample by baseline vitamin D levels revealed that participants with vitamin D insufficiency (≤ 75 nmol/L) significantly improved short physical performance battery score (1.06, p = 0.04), fast gait speed (6.28, p = 0.004) and vitamin D levels (25.73, p = <0.0001). Pre-frail individuals, as well as those with sufficient vitamin D levels (> 75 nmol/L) made no significant improvement in any outcome. Conclusions: Vitamin D supplementation using 4000 IU/daily is safe and has a modest beneficial effect on physical performance for frail individuals and those with insufficient vitamin D levels. Participants with vitamin D insufficiency (≤ 75 nmol/L) showed greater benefits. Our feasibility study provides results to help calculate effect size for a future RCT.

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Vitamin D Insufficiency and Deficiency and Mortality from Respiratory Diseases in a Cohort of Older Adults: Potential for Limiting the Death Toll during and beyond the COVID-19 Pandemic?

Nutrients ◽

10.3390/nu12082488 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2488 ◽

Cited By ~ 7

Author(s):

Hermann Brenner ◽

Bernd Holleczek ◽

Ben Schöttker

Keyword(s):

Older Adults ◽

Vitamin D ◽

Respiratory Disease ◽

Vitamin D3 ◽

Respiratory Diseases ◽

Vitamin D Insufficiency ◽

Blood Levels ◽

Respiratory Mortality ◽

Disease Mortality ◽

Vitamin D3 Supplementation

The COVID-19 pandemic goes along with increased mortality from acute respiratory disease. It has been suggested that vitamin D3 supplementation might help to reduce respiratory disease mortality. We assessed the prevalence of vitamin D insufficiency and deficiency, defined by 25-hydroxyvitamin D (25(OH)D) blood levels of 30–50 and <30 nmol/L, respectively, and their association with mortality from respiratory diseases during 15 years of follow-up in a cohort of 9548 adults aged 50–75 years from Saarland, Germany. Vitamin D insufficiency and deficiency were common (44% and 15%, respectively). Compared to those with sufficient vitamin D status, participants with vitamin D insufficiency and deficiency had strongly increased respiratory mortality, with adjusted hazard ratios (95% confidence intervals) of 2.1 (1.3–3.2) and 3.0 (1.8–5.2) overall, 4.3 (1.3–14.4) and 8.5 (2.4–30.1) among women, and 1.9 (1.1–3.2) and 2.3 (1.1–4.4) among men. Overall, 41% (95% confidence interval: 20–58%) of respiratory disease mortality was statistically attributable to vitamin D insufficiency or deficiency. Vitamin D insufficiency and deficiency are common and account for a large proportion of respiratory disease mortality in older adults, supporting the hypothesis that vitamin D3 supplementation could be helpful to limit the burden of the COVID-19 pandemic, particularly among women.

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Bone geometry is correlated with arterial stiffness in overweight older adults with vitamin D insufficiency

Endocrine Abstracts ◽

10.1530/endoabs.56.p171 ◽

2018 ◽

Author(s):

Alexander Rodriguez ◽

Cecilia Xu ◽

Lachlan McMillan ◽

Velandai Srikanth ◽

David Scott ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Arterial Stiffness ◽

Bone Geometry ◽

Vitamin D Insufficiency

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Serum Vitamin D and Cingulate Cortex Thickness in Older Adults: Quantitative MRI of the Brain

Current Alzheimer Research ◽

10.2174/1567205016666191113124356 ◽

2019 ◽

Vol 16 (11) ◽

pp. 1063-1071 ◽

Cited By ~ 1

Author(s):

Gonzague Foucault ◽

Guillaume T Duval ◽

Romain Simon ◽

Olivier Beauchet ◽

Mickael Dinomais ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Brain Mri ◽

Serum Vitamin ◽

Cingulate Cortex ◽

Posterior Cingulate Cortex ◽

Vitamin D Insufficiency ◽

Anterior Cingulate ◽

Posterior Cingulate ◽

Significant Difference

Background: Vitamin D insufficiency is associated with brain changes, and cognitive and mobility declines in older adults. Method: Two hundred and fifteen Caucasian older community-dwellers (mean±SD, 72.1±5.5years; 40% female) received a blood test and brain MRI. The thickness of perigenual anterior cingulate cortex, midcingulate cortex and posterior cingulate cortex was measured using FreeSurfer from T1-weighted MR images. Age, gender, education, BMI, mean arterial pressure, comorbidities, use of vitamin D supplements or anti-vascular drugs, MMSE, GDS, IADL, serum calcium and vitamin B9 concentrations, creatinine clearance were used as covariables. Results: Participants with vitamin D insufficiency (n=80) had thinner total cingulate thickness than the others (24.6±1.9mm versus 25.3±1.4mm, P=0.001); a significant difference found for all 3 regions. Vitamin D insufficiency was cross-sectionally associated with a decreased total cingulate thickness (β=- 0.49, P=0.028). Serum 25OHD concentration correlated positively with the thickness of perigenual anterior (P=0.011), midcingulate (P=0.013) and posterior cingulate cortex (P=0.021). Conclusion: Vitamin D insufficiency was associated with thinner cingulate cortex in the studied sample of older adults. These findings provide insight into the pathophysiology of cognitive and mobility declines in older adults with vitamin D insufficiency.

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Letter on the article “Supplementation with 80,000 UI vitamin D3/month between November and April corrects vitamin D insufficiency without overdosing: Effect on serum 25-hydroxyvitamin D serum concentrations”

La Presse Médicale ◽

10.1016/j.lpm.2017.08.007 ◽

2017 ◽

Vol 46 (10) ◽

pp. 983-984

Author(s):

Rémi Bardet ◽

Anne-Lise Trémeau ◽

Aurore Lebeau ◽

Charlotte Poline

Keyword(s):

Vitamin D ◽

Vitamin D3 ◽

Vitamin D Insufficiency ◽

Serum Concentrations ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

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Effects of Stratified Vitamin D Supplementation in Middle-Aged and Elderly Individuals with Vitamin D Insufficiency

Hormone and Metabolic Research ◽

10.1055/a-0746-5031 ◽

2018 ◽

Vol 50 (10) ◽

pp. 747-753

Author(s):

Yanhui Lu ◽

Xiaomin Fu ◽

Lili Zhang ◽

Minyan Liu ◽

Xiaoling Cheng ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D3 ◽

Intervention Group ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Control Group ◽

Middle Aged ◽

Oral Vitamin ◽

Severe Vitamin

AbstractThe incidence of vitamin D deficiency is high globally, and vitamin D supplementation draws particular attention. The objective of this study was to investigate the effects of stratified vitamin D supplementation in middle-aged and elderly individuals with vitamin D insufficiency in Beijing. A total of 448 subjects aged over 40 years old were selected from a community in Beijing. Among them, 100 middle-aged and elderly people with vitamin D insufficiency were randomly selected on a voluntary basis. They were further divided into control group and intervention group. The control group received health education and lifestyle guidance, and the intervention group received lifestyle guidance and vitamin D supplementation for nine months. The doses were stratified as follows: for vitamin D insufficiency, oral vitamin D3 supplement was given at 5000 IU/w; for mild vitamin D deficiency, oral vitamin D3 supplement was given at 10 000 IU/w; for severe vitamin D deficiency, oral vitamin D3 supplement was given at 15 000 IU/w. Safety evaluation was conducted after three-month treatment. The intervention group consisted of 8%, 62%, and 30% of cases who had vitamin D insufficiency, mild vitamin D deficiency, and severe vitamin D deficiency, respectively, which were similar with the control group. It showed that the blood 25(OH)D level increased significantly in the intervention group, from 14.30±4.30 ng/ml to 33.62±6.99 ng/ml (p<0.001), in contrast to insignificant change in the control group. Stratified vitamin D supplementation effectively increased the blood 25(OH)D level, as well as the number of cases with corrected vitamin D insufficiency or deficiency.

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