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

Abstract

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.

Vitamin D's potential to reduce the risk of hospital-acquired infections

“…However, vitamin D deficiency can increase this probability by decreasing the host innate defense mechanisms. We have suggested the use of vitamin D in the management of acute illness in elderly patients and those with an underlying chronic illness 117 . This review aims to show the potential benefits of vitamin D in infection.…”

Vitamin D Deficiency in Community-Dwelling Elderly Is Not Associated with Age-Related Macular Degeneration

“…This limited conversion is aggravated by changes in lifestyle such as low sunlight exposure because of frailty, clothing style, and decreased outdoor activity. In addition, insufficient dietary intake, intestinal malabsorption (4), decline of the renal production of 1,25-dihydroxycholecalciferol (5), polypharmacy, and diseases that interfere with vitamin D metabolism contribute to render the aging population, in general, at risk of vitamin D deficiency, especially in winter seasons and at higher latitudes (1,2).…”

“…Comparisons of characteristics with vitamin D status were examined with multinomial regression analysis adjusted for age and gender 4. Fasting blood glucose of $7 mmol/L, nonfasting blood glucose of $11.0 mmol/L, and/or antidiabetic medication use 5. Average systolic blood pressure of $140 mm Hg, average diastolic blood pressure of $90 mm Hg, and/or antihypertensive medicationuse.…”

EMTN em hospitais dos Municípios do Alto do Tietê

“…Portanto inclui: recordatório alimentar (11), visando a análise da ingestão oral de um dia típico, antes da internação e de fatores que possam afetar esse consumo como:déficits sensoriais, coordenação motora fina ou disfunção na mastigação e deglutição (12) além dos achados físicos sendo a perda de peso o melhor preditor de risco de desnutrição. Os profissionais da saúde devem atentar para a depleção nutricional que pode ocorrer mesmo antes da detecção da perda de peso (comum em pacientes gravemente doentes ou com trauma) (12).…”

“…Perda de gordura subcutânea (localizada ou generalizada); 5. Acúmulo de líquido (12). Para que a avaliação nutricional seja realizada de maneira correta, os parâmetros nutricionais devem ser sistematicamente documentados para que as necessidades nutricionais possam ser determinadas.…”