Testing for Vitamin D Deficiency in Veterans—Is There a Seasonal Bias?

Peiris, Alan N.; Bailey, Beth A.; Manning, Todd; Kuriacose, Reena; Copeland, Rebecca; Garrett, Linda

doi:10.1016/j.jamda.2009.11.004

Cited by 13 publications

(5 citation statements)

References 23 publications

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“…To determine if the cost differences by rurality status could be explained by vitamin D levels, analyses were run separately entering vitamin D levels after controlling for background variables and season of vitamin D draw, as all were associated with rurality status in the current sample. Season of vitamin D draw was coded as first quarter of the year versus the rest of the year, as research has shown vitamin D levels to be lowest during the first quarter 46 …”

Section: Methodsmentioning

confidence: 99%

The Impact of Living in Rural and Urban Areas: Vitamin D and Medical Costs in Veterans

Bailey

Manning

Peiris

2012

The Journal of Rural Health

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Purpose: Living in a rural region is associated with significant health disparities and increased medical costs. Vitamin D deficiency, which is increasingly common, is also associated with many adverse health outcomes. The purpose of this study was to determine whether rural‐urban residence status of veterans was related to vitamin D levels, and to determine if this factor also influenced medical costs/service utilization. Additionally explored was whether vitamin D differences accounted for part of the association between area of residence and medical costs/service utilization. Methods: Medical records of 9,396 veterans from 6 Veterans Administration Medical Centers were reviewed for variables of interest including county of residence, vitamin D level, medical costs and service utilization, and background variables. Rurality status was classified as large metropolitan, urban, and rural. Findings: The 3 rurality status groups differed significantly in vitamin D levels, with the highest levels observed for urban residents, followed by rural residents, and the lowest for large metro residents. Compared with urban residents, large metro residents were 49% more likely, while rural residents were 20% more likely, to be vitamin D deficient. Both rural and large metro residents had higher medical costs, and they were significantly more likely to be hospitalized. Vitamin D levels explained a statistically significant amount of the relationship between rurality status and medical costs/service utilization. Conclusions: Vitamin D deficiency may be an additional health disparity experienced by both rural and inner‐city veterans, and patients residing in these locations should be considered at increased risk for deficiency and routinely tested.

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Section: Methodsmentioning

confidence: 99%

The Impact of Living in Rural and Urban Areas: Vitamin D and Medical Costs in Veterans

Bailey

Manning

Peiris

2012

The Journal of Rural Health

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“…All older persons who are not receiving at least 1000 IU of vitamin D a day should have their 25(OH) vitamin D level measured (82)(83)(84)(85)(86). Low vitamin D levels are related to sarcopenia, falls, hip fracture, heart disease and increased mortality.…”

Section: Other Screening Testsmentioning

confidence: 99%

Assessment of malnutrition in older persons: A focus on the mini nutritional assessment

Morley

2011

The Journal of nutrition, health and aging

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“…While current health insurance mandates the presence of symptoms such as fatigue and arthralgias prior to checking vitamin D status, a more liberal policy may encourage more active treatment with better clinical outcomes. An argument could be made for checking 25(OH)D levels at least twice yearly on any patient at risk, once in the early spring for the nadir and once in the late summer for a peak level 6 . If the patient has been stable on a fixed dose of vitamin D without a variance in other factors known to influence vitamin D, then a yearly check of vitamin D status may be appropriate.…”

Section: Treatment Of Vitamin D Deficiencymentioning

confidence: 99%

“…An argument could be made for checking 25(OH)D levels at least twice yearly on any patient at risk, once in the early spring for the nadir and once in the late summer for a peak level. 6 If the patient has been stable on a fixed dose of vitamin D without a variance in other factors known to influence vitamin D, then a yearly check of vitamin D status may be appropriate.…”

Section: Treatment Of Vitamin D Deficiencymentioning

confidence: 99%

“…A combination of inadequate exposure to solar radiation and less than optimal dietary intake 5 has resulted in increasingly widespread vitamin D deficiency. In US Veterans, the average monthly 25(OH)D levels were below 30 ng/mL throughout all seasons 6 and it is likely that seasonal variation may not be a major contributor to vitamin D deficiency. Diet may also play a significant role in vitamin D deficiency 7 .…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D deficiency: Implications for acute care in the elderly and in patients with chronic illness

Youssef

Abbassi

Cutchins

et al. 2011

Geriatrics Gerontology Int

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There is evidence that the vast majority of hospitalized patients have vitamin D deficiency. Vitamin D deficiency is a poorly recognized pandemic with evidence to indicate inadequate testing and monitoring of response to treatment in high-risk populations. Vitamin D receptors are ubiquitous in the human body and while the endocrine effects of vitamin D are well recognized, the autocrine and paracrine effects of this steroid hormone are less well appreciated. These functions include antimicrobial and immunomodulation effects as well benefits on cardiovascular health, autoimmune disease, cancer and metabolism. Vitamin D deficiency increases mortality and even a modest amount of vitamin D may enhance longevity. Emerging evidence suggests that a vitamin D replete state carries significant health benefits in acute illness. In this review, we discuss the role of vitamin D deficiency and potential benefits in treating this deficiency focusing on the implications for managing acute illness in elderly patients and those with an underlying chronic illness.

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Testing for Vitamin D Deficiency in Veterans—Is There a Seasonal Bias?

Cited by 13 publications

References 23 publications

The Impact of Living in Rural and Urban Areas: Vitamin D and Medical Costs in Veterans

The Impact of Living in Rural and Urban Areas: Vitamin D and Medical Costs in Veterans

Assessment of malnutrition in older persons: A focus on the mini nutritional assessment

Vitamin D deficiency: Implications for acute care in the elderly and in patients with chronic illness

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