Quality-of-life indicators and falls due to vitamin D deficiency

Abstract

ObjectiveTo determine whether the number of falls and quality-of-life indicators relate to serum levels of vitamin D, parathyroid hormone (PTH), and calcium levels.DesignA prospective study.ParticipantsPatients being admitted with a fall with or without sustaining a fragility fracture post fall.MeasurementsMeasured frequency of falling, SF-12 questionnaire, serum concentrations of 25-hydroxyvitamin D, calcium, and PTH levels before and after treatment with vitamin D supplementation.ResultsThe mean age (N=38) of the cohort was 80.2±12. In all, 76.3% of the cohort had sustained a fragility fracture after the fall. The cohort was vitamin D deficient with the pretreatment mean value of 24.2±17 nmol/L and posttreatment mean value of 99±40 nmol/L with a statistically significant mean difference of 74.7 nmol/L (confidence interval [CI] 61.27–88.3), P=0.001. The levels of calcium and PTH were statistically significant after treatment with a mean difference of 0.16 (CI 0.1–0.2), P=0.001, and 3.7 (CI −4.8 to −2.5), P=0.001, respectively. After treatment, the mean difference of physical component score (PCS) and mental component score for the whole cohort was 2.9 (CI −0.69 to 6.6), P=0.10, and 1.05 (CI −2.6 to 4.7), P=0.56, respectively. However, a subgroup analysis for cohort aged ≤70 years provided a statistically significant effect on PCS with a mean difference of 8.9 (CI 1.3–16.4), P=0.03, but a statistically insignificant improvement in mental component score with a mean difference of 6.0 (CI −17 to −5.0), P=0.20. However, a statistically significant improvement in PCS SF-12 was observed in patients ≤70 years of age 2.9 (1.3–16.4), P=0.03. The mean number of falls for the whole cohort pre- and posttreatment was 1.11±0.92 vs 0.97±0.99 (P=0.68), respectively.ConclusionPatients who had fallen and sustained fragility fracture had lower serum 25-dihydroxyvitamin D and higher serum PTH levels. Our study demonstrates that there is no statistically significant improvement in the number of falls after treatment with vitamin D. Overall, vitamin D levels improved significantly, this is despite quality-of-life indicators showing a mean increase in PCS but not a statistically significant improvement. However, statistically significant improvement in PCS was observed in group aged ≤70 years after vitamin D supplementation.

Association between Vitamin D Supplementation and Mental Health in Healthy Adults: A Systematic Review

“…The study design and basic details of the studies included in the systematic review [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ] are presented in Table 2 . The included studies were conducted mainly in the United States of America [ 30 , 31 ], Norway [ 33 , 38 ], and Poland [ 40 , 43 ], while single studies were conducted also in Canada [ 29 ], Australia [ 32 ], United Kingdom [ 34 ], Finland [ 35 ], Iran [ 36 ], New Zealand [ 37 ], Netherlands [ 40 ], and Switzerland [ 41 ].…”

“…The study design and basic details of the studies included in the systematic review [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ] are presented in Table 2 . The included studies were conducted mainly in the United States of America [ 30 , 31 ], Norway [ 33 , 38 ], and Poland [ 40 , 43 ], while single studies were conducted also in Canada [ 29 ], Australia [ 32 ], United Kingdom [ 34 ], Finland [ 35 ], Iran [ 36 ], New Zealand [ 37 ], Netherlands [ 40 ], and Switzerland [ 41 ]. A number of studies were conducted in community-based samples, but some of them included specific groups of outpatients visiting an endocrinology clinic [ 29 ], patients with vitamin D deficiency or low 25(OH)D blood levels [ 30 , 33 ], patients with a prior fall [ 35 , 41 ], patients with functional limitations [ 40 ], pregnant women under prenatal care [ 36 ], marathon runners [ 39 ], and participants of a training program [ 42 ].…”

“…The characteristics of the groups studied within the studies included in the systematic review is presented in Table 3 . The included intervention studies were conducted mainly in small samples of respondents—less than 100 respondents [ 29 , 30 , 34 , 39 , 42 ]—or medium ones—less than 500 [ 33 , 35 , 36 , 37 , 38 , 40 , 41 ]—but two studies were conducted in large samples involving over 2000 [ 32 ] and over 80,000 participants [ 31 ]. The inclusion criteria mainly included the 25(OH)D blood level [ 29 , 30 , 32 , 33 , 38 , 40 , 42 ], but in some studies, history of falls was also taken into account [ 34 , 35 , 41 ].…”

“…The characteristics of the exposure and outcome studied within the studies included in the systematic review are presented in Table 4 . The intervention studies included in the present review evaluated the effects of various doses of vitamin D [ 29 , 41 ], compared the supplementation results with the placebo effect [ 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 ], compared the outcome with no supplementation [ 31 ], or observed the effect of a specific dose applied [ 30 , 34 , 42 ]. In the majority of studies, vitamin D was applied for a period of a few months (6 months or shorter) [ 29 , 30 , 33 , 34 , 36 , 37 , 38 , 42 ], while in some, the supplementation protocol extended for one year [ 40 , 41 ] or even longer [ 31 , 32 , 35 ]; but, in one study, vitamin D was administered for only 2 weeks [ 39 ].…”

“…The intervention studies included in the present review evaluated the effects of various doses of vitamin D [ 29 , 41 ], compared the supplementation results with the placebo effect [ 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 ], compared the outcome with no supplementation [ 31 ], or observed the effect of a specific dose applied [ 30 , 34 , 42 ]. In the majority of studies, vitamin D was applied for a period of a few months (6 months or shorter) [ 29 , 30 , 33 , 34 , 36 , 37 , 38 , 42 ], while in some, the supplementation protocol extended for one year [ 40 , 41 ] or even longer [ 31 , 32 , 35 ]; but, in one study, vitamin D was administered for only 2 weeks [ 39 ]. The assessed mental health outcomes included mainly depressive symptoms, or depression [ 30 , 31 , 33 , 35 , 36 , 37 , 38 , 40 , 41 , 42 ], well-being [ 29 , 32 , 35 ], quality of life [ 35 , 40 , 42 ], mood [ 29 , 37 , 39 ], general mental component [ 32 , 34 , 41 ], and anxiety [ 37 ,…”