Study highlights need to treat female nursing-home patients for vitamin D deficiency

The majority of older women in nursing homes are likely to be deficient in vitamin D during winter months, and those with the lowest levels are at a significantly increased risk of death, according to a study published online February 8, in the Journal of Clinical Endocrinology & Metabolism.

Vitamin D deficiency is extraordinarily high among nursing-home residents, stated lead investigator Stefan Pilz, of the Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria, and colleagues.

“Limited sunlight access in concert with impaired vitamin D synthesis of the aging skin as well as nutritional deficits may likewise contribute to this high prevalence of vitamin D deficiency,” the authors said.

And, although 25-hydroxyvitamin D (25[OH]D) concentrations are associated with an increased risk of death in the general population, there is only 1 study looking at the measurement for nursing-home patients. As a result, the researchers conducted a prospective cohort study to evaluate whether 25(OH)D concentrations are associated with mortality in elderly female nursing-home patients.

The researchers examined 961 female patients from 95 nursing homes in Austria and found 92.8% had 25(OH)D levels below the recommended level of 50 nmol/L. After a mean follow-up time of 27 months, the researchers noted 264 patient deaths (30% of the study cohort). These results, they said, are in line with previous studies, suggesting that although well known, there have been no strategies put in place to prevent and treat vitamin D deficiency in this population.

“In view of these findings and the existing literature on adverse effects of vitamin D deficiency, there exists now an urgent need for effective strategies to improve vitamin D status in older institutionalized patients,” the authors concluded. And, although they acknowledge limitations of the study, they stated that it would be reasonable to initiate supplementation in this population.