Vitamin D deficiency in homebound elderly persons

Gloth, F. Michael; Gundberg, Caren M.; Hollis, B W; Haddad, John G.; Tobin, Jordan D.

doi:10.1097/00004045-199607000-00012

Cited by 48 publications

(61 citation statements)

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“…In elderly persons, however, cutaneous synthesis of vitamin D is clearly reduced and it is unclear, whether sufficient amounts can be produced endogenously (Need et al, 1993;Holick, 1994). Definitely, homebound elderly are at high risk of vitamin D deficiency with intake levels like these (Gloth et al, 1995;Sahota & Hosking 2001). In the present study, only 2% of all participants were unable to leave the house.…”

Section: Dietary Intake Of Elderly People In Germany D Volkert Et Alcontrasting

confidence: 53%

Energy and nutrient intake of young-old, old-old and very-old elderly in Germany

et al. 2004

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Background: Reliable information about the nutritional status of elderly people in Germany is lacking. Objective: To describe energy and nutrient intake of elderly people living in private households in Germany with special focus on age-related differences in the elderly. Design: Descriptive nationwide cross-sectional study. Setting: Germany, 1998. Subjects: A random sample of 4020 elderly men and women living independently in private households stratified in three age groups (65-74, 75-84, 85 þ y), of which 1550 participated and 1372 (789 female subjects) provided reliable 3-day estimated dietary records. Results: The median daily energy intake was 2207 kcal (9.2 MJ) in men and 1994 kcal (8.3 MJ) in women without difference between the age groups. Protein intake amounted to 91 and 81 g/day, respectively, corresponding to 1.2 g/kg body weight per day. The median intake was well above the recommended amount for all nutrients except dietary fibre, calcium, vitamin D and folate, where 38, 35, 75 and 37% did not reach two-thirds of the recommended amount. An age-related decline was observed for calcium intake in male and for dietary fibre, water, calcium, magnesium, iron, vitamins A, E, C and thiamin intake in female participants; however, the overall picture was unaffected by these differences. Conclusions: Dietary intake in these independently living elderly, including the very-old, is adequate for most of the evaluated nutrients. Increased intake of foods rich in dietary fibre, calcium, vitamin D and folate as well as regular sunlight exposure is recommended in order to optimize nutrient supply in this population group.

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Section: Dietary Intake Of Elderly People In Germany D Volkert Et Alcontrasting

confidence: 53%

Energy and nutrient intake of young-old, old-old and very-old elderly in Germany

et al. 2004

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“…This 'cut-off' value is similar to that proposed by Haden et al (1999): 25 ng/ml, Melin et al (1999): 30 ng/ml and Chapuy et al (1997): 31 ng/ml, and is similar to the cutoff level associated with an increase in bone markers (Need et al, 2002). However, other authors have proposed lower and higher levels as cutoff values: 12-16 ng/ ml (Ooms et al, 1995;Gloth et al, 1995;Thomas et al, 1998) and 44 ng/ml, respectively . This last value is very similar to the level proposed as being desirable to diminish fracture risk (Chapuy et al, 1992;Mc Kenna & Freaney, 1998).…”

Section: Discussionmentioning

confidence: 99%

“…A new category of desirable levels has been introduced, based on the 25OHD levels required to diminish hip fractures (Chapuy et al, 1992;Mc Kenna & Freaney, 1998). Reports in the literature have established serum 25OHD levels below which PTH begins to increase to be between 12 and 20 ng/ml (Bouillon et al, 1987;Gloth et al, 1995;Ooms et al, 1995;Mc Kenna & Freaney, 1998). More recently, higher levels of 25OHD have been proposed as limits of insufficiency: 25,31 or 44 ng/ml (Chapuy et al, 1997;Haden et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

High prevalence of vitamin D insufficiency in healthy elderly people living at home in Argentina

et al. 2004

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Objective: To evaluate the nutritional status of vitamin D in urban populations of healthy elderly people living at home, in different regions of Argentina. Design: Cross-sectional study. Subjects: In total, 386 ambulatory subjects over 65 y of age from seven cities (between latitude 261S and 551S) were asked to participate between the end of winter and the beginning of spring. Of these, 369 accepted, 30 were excluded because of medical history or abnormal biochemical determinations. Finally, 339 subjects (226 women and 113 men) (X7s.d.) (71.37 5.2 y) were included. Results: Serum 25OHD levels were lowest in the South (latitude range: 411S-551S): 14.275.6 ng/ml (Po0.0001vs North and Mid regions); highest in the North (261S-271S): 20.777.4 ng/ml (Po0.03 vs Mid, Po0.0001vs South); and intermediate in the Mid region (331S-341S) 17.978.2 ng/ml. Serum mid-molecule PTH (mmPTH) and 25OHD were inversely related: (r ¼ À0.24, Po0.001). A cutoff level of 25OHD at which serum mmPTH levels began to increase was established at 27 ng/ml. A high prevalence (87-52%) of subjects with 25OHD levels in the deficiency-insufficiency range (25OHD levels o20 ng/ml) was detected. Conclusion: This study shows that vitamin D deficiency/insufficiency in the elderly is a worldwide problem. Correction of this deficit would have a positive impact on bone health of elderly people. Sponsorship: Asociació n Argentina de Osteología y Metabolismo Mineral (AAOMM).

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“…The lower serum calcium concentration causes increased PTH secretion, stimulating the production of 1,25(OH) 2 D. By this mechanism, serum 1,25(OH) 2 D is kept at (nearly) normal concentrations at the expense of a raised PTH concentration, referred to as secondary hyperparathyroidism. This secondary hyperparathyroidism can result in increased bone turnover and bone loss mainly from cortical sites such as the femoral neck (Gloth, 1995;Schmidt-Gayk et al, 1997;Gloth, 1999). Impaired vitamin D status has also been shown to affect muscle strength (Boland, 1986), body sway and risk of falling (Stein et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Vitamin D insufficiency in older female community-dwelling acute hospital admissions and the response to supplementation

et al. 2006

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Objectives: A significant proportion of the older population may exhibit vitamin D insufficiency. We sought to establish the proportion of 25-hydroxyvitamin D (25OHD) insufficient individuals in an older female cohort presenting for acute medical admission and how they responded to supplementation. Design: A prospective cohort study. Setting: Hospital admissions followed up as a population-based study. Subjects: A total of 114 consecutive female acute medical admissions aged over 65 years from November 2003 to January 2004 were enrolled. All admissions with hypercalcaemia, metabolic bone disease (other than osteoporosis/osteomalacia) and creatinine 4150 mmol/l were excluded. Interventions: iPTH, calcium and 25OHD levels were measured in each patient. Of the total, 22 were already receiving calcium and vitamin D supplementation at enrolment. The remaining 92 were commenced on 800 IU of vitamin D and 1 g calcium, and levels were reassessed after supplementation for 3 months. Results: 25-Hydroxyvitamin D insufficiency, as defined by a 25OHD concentration of o50 nmol/l, was present in 86 (75.4%) patients at initial assessment (mean 35.8 nmol/l, s.d. 23.3). Secondary hyperparathyroidism was present in only 36.7% of those with 25OHD deficiency at baseline. Of the total, 51 (44.7%) patients presented for follow-up. 25-Hydroxyvitamin D concentration increased in this group from 42.1 nmol/l (s.d. 26.6) to 59.5 nmol/l (s.d. 27.4) after supplementation, Po0.001, but 18(35.3%) still remained deficient. There was no significant change in iPTH or calcium following supplementation. Assessment of compliance revealed 6 (11.7%) admitted to partial or non-compliance. Conclusions: Insufficiency of 25OHD was very common in this cohort. Despite calcium and vitamin D supplementation, 25OHD concentrations failed to reach normality in a significant proportion. Maintaining vitamin D and calcium intake at the level of current recommended doses may not be sufficient to ensure adequate 25OHD stores.

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Vitamin D deficiency in homebound elderly persons

Cited by 48 publications

References 0 publications

Energy and nutrient intake of young-old, old-old and very-old elderly in Germany

Energy and nutrient intake of young-old, old-old and very-old elderly in Germany

High prevalence of vitamin D insufficiency in healthy elderly people living at home in Argentina

Vitamin D insufficiency in older female community-dwelling acute hospital admissions and the response to supplementation

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