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Vitamin D deficiency in elderly people in Swedish nursing homes is associated with increased mortality

Samefors, Maria ; Ostgren, Carl Johan ; Mölstad, Sigvard LU ; Lannering, Christina ; Midlöv, Patrik LU orcid and Tengblad, Anders (2014) In European Journal of Endocrinology 170(5). p.667-675
Abstract
Objective: Institutionalised elderly people at northern latitudes may be at elevated risk for vitamin D deficiency. In addition to osteoporosis-related disorders, vitamin D deficiency may influence several medical conditions conferring an increased mortality risk. The aim of this study was to explore the prevalence of vitamin D deficiency and its association with mortality. Design: The Study of Health and Drugs in the Elderly (SHADES) is a prospective cohort study among elderly people (>65 years) in 11 nursing homes in Sweden. Methods: We analysed the levels of 25-hydroxyvitamin D-3 (25(OH)D-3) at baseline. Vital status of the subjects was ascertained and hazard ratios (HRs) for mortality according to 25(OH)D-3 quartiles were... (More)
Objective: Institutionalised elderly people at northern latitudes may be at elevated risk for vitamin D deficiency. In addition to osteoporosis-related disorders, vitamin D deficiency may influence several medical conditions conferring an increased mortality risk. The aim of this study was to explore the prevalence of vitamin D deficiency and its association with mortality. Design: The Study of Health and Drugs in the Elderly (SHADES) is a prospective cohort study among elderly people (>65 years) in 11 nursing homes in Sweden. Methods: We analysed the levels of 25-hydroxyvitamin D-3 (25(OH)D-3) at baseline. Vital status of the subjects was ascertained and hazard ratios (HRs) for mortality according to 25(OH)D-3 quartiles were calculated. Results: We examined 333 study participants with a mean follow-up of 3 years. A total of 147 (44%) patients died within this period. Compared with the subjects in Q4 (25(OH)D-3 >48 nmol/l), HR (with 95% CI) for mortality was 2.02 (1.31-3.12) in Q1 (25(OH)D-3 <29 nmol/l) (P<0.05); 2.03 (1.32-3.14) in Q2 (25(OH)D-3 30-37 nmol/l) (P<0.05) and 1.6 (1.03-2.48) in Q3 (25(OH)D-3 38-47 nmol/l) (P<0.05). The mean 25(OH)D-3 concentration was 40.2 nmol/l (S.D. 16.0) and 80% had 25(OH)D-3 below 50 nmol/l. The vitamin D levels decreased from baseline to the second and third measurements. Conclusions: Vitamin D deficiency was highly prevalent and associated with increased mortality among the elderly in Swedish nursing homes. Strategies are needed to prevent, and maybe treat, vitamin D deficiency in the elderly in nursing homes and the benefit of vitamin D supplementation should be evaluated in randomised clinical trials. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Endocrinology
volume
170
issue
5
pages
667 - 675
publisher
Society of the European Journal of Endocrinology
external identifiers
  • wos:000336728100008
  • scopus:84899758818
  • pmid:24520134
ISSN
1479-683X
DOI
10.1530/EJE-13-0855
language
English
LU publication?
yes
id
3bd9186b-80cd-4dfa-b23c-40c81936979c (old id 4558472)
date added to LUP
2016-04-01 10:41:29
date last changed
2022-04-28 00:27:48
@article{3bd9186b-80cd-4dfa-b23c-40c81936979c,
  abstract     = {{Objective: Institutionalised elderly people at northern latitudes may be at elevated risk for vitamin D deficiency. In addition to osteoporosis-related disorders, vitamin D deficiency may influence several medical conditions conferring an increased mortality risk. The aim of this study was to explore the prevalence of vitamin D deficiency and its association with mortality. Design: The Study of Health and Drugs in the Elderly (SHADES) is a prospective cohort study among elderly people (&gt;65 years) in 11 nursing homes in Sweden. Methods: We analysed the levels of 25-hydroxyvitamin D-3 (25(OH)D-3) at baseline. Vital status of the subjects was ascertained and hazard ratios (HRs) for mortality according to 25(OH)D-3 quartiles were calculated. Results: We examined 333 study participants with a mean follow-up of 3 years. A total of 147 (44%) patients died within this period. Compared with the subjects in Q4 (25(OH)D-3 &gt;48 nmol/l), HR (with 95% CI) for mortality was 2.02 (1.31-3.12) in Q1 (25(OH)D-3 &lt;29 nmol/l) (P&lt;0.05); 2.03 (1.32-3.14) in Q2 (25(OH)D-3 30-37 nmol/l) (P&lt;0.05) and 1.6 (1.03-2.48) in Q3 (25(OH)D-3 38-47 nmol/l) (P&lt;0.05). The mean 25(OH)D-3 concentration was 40.2 nmol/l (S.D. 16.0) and 80% had 25(OH)D-3 below 50 nmol/l. The vitamin D levels decreased from baseline to the second and third measurements. Conclusions: Vitamin D deficiency was highly prevalent and associated with increased mortality among the elderly in Swedish nursing homes. Strategies are needed to prevent, and maybe treat, vitamin D deficiency in the elderly in nursing homes and the benefit of vitamin D supplementation should be evaluated in randomised clinical trials.}},
  author       = {{Samefors, Maria and Ostgren, Carl Johan and Mölstad, Sigvard and Lannering, Christina and Midlöv, Patrik and Tengblad, Anders}},
  issn         = {{1479-683X}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{667--675}},
  publisher    = {{Society of the European Journal of Endocrinology}},
  series       = {{European Journal of Endocrinology}},
  title        = {{Vitamin D deficiency in elderly people in Swedish nursing homes is associated with increased mortality}},
  url          = {{http://dx.doi.org/10.1530/EJE-13-0855}},
  doi          = {{10.1530/EJE-13-0855}},
  volume       = {{170}},
  year         = {{2014}},
}