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The study assessed serum Vitamin D (Vit D) concentration status in 240 patients aged 70 and above within the Department of Geriatrics, Medical University of Bialystok, Poland, exploring associations with age, sex, BMI and Vit D supplementation.
โDespite recommendations for Vit D supplementation having been in place for over a decade, the percentage of seniors admitted to the Department of Geriatrics with Vit Dย deficiency and inadequacy remains alarmingly high,” the Polish researchers wrote in the journalย Nutrients.ย โโThis emphasises the urgent need for further actions to address this concerning trend.โ
The need for Vit Dโ
Vit Dย plays a crucial role in physiological processes, particularly in maintaining the skeletal system through its influence on calcium-phosphate metabolism.ย
Deficiency in older adults is linked to various musculoskeletal disorders, andย previous studiesโย suggest that maintaining optimal Vit Dย levels, along with physical activity and proper nutrition, may reduce the risk of related diseases, positively impacting the overall quality of life.
Lowย Vit Dย levels are associated withย cardiovascular diseasesโ,ย compromised immunityโ,ย depressionโย andย neurodegenerative disordersโ. In addition,ย some studiesโย have shown that maintaining an appropriate Vit Dย level reduces the risk of developing certain cancers.
Vit Dย regulates calcium and phosphate metabolismโ, influencing bone metabolism, promoting bone mineralization by osteoblasts, and increasing the absorption of calcium and phosphates in the intestine.ย Itย exerts effects by activating the membrane receptorโย (MARRS, membrane-associated, rapid response steroid-binding) and Vit Dย receptors (VDR) present in the nuclei of most cells. These transcription factors regulate the expression of over 2,000 genes responsible for cell differentiation, proliferation and apoptosis.
In human plasmaโ, Vit Dย is present in the forms of cholecalciferol (Vit D3), formed in the skin from 7-dehydrocholesterol under the influence of UV-B rays, or ergocalciferol (Vit D2), obtained as a component of plant-based foods.ย In the absence of sufficient biosynthesis in the skin, which is common among older populations,ย dietary intake and supplementation become a critical source of Vit Dโ.
For younger seniors (65โ75 years), due to decreased efficacy of the skin synthesis, a dose of 1,000โ2,000 IU/day (25โ50 ยตg/day) is recommended throughout the year. In older seniors (>75โ89 years) and the oldest individuals (90 years and older), this recommendationโ jumps to 2,000โ4,000 IU/day (50โ100 ยตg/day).
Despite recommendations and global awareness, Vit D deficiency remains a challenge, especially among vulnerable groups. Between 40% and 80% of the older populationย struggle with Vit D deficiencyโ, andย high percentages of inadequate Vit D levels among seniors are foundโย regardless of gender, skin colour or place of residence.ย
A study conducted in Polandโย from 2016 to 2020 showed that Vit D deficiency (25(OH)D concentration <20 ng/mL) was present in half of the participants over the age of 60, with the authors calling for Vit D supplementation when establishing the fundamental canon of public health activities for seniors in Poland.ย
โThe research did not include the elderly living in care institutions or those who are hospitalised, more disabled or diseased,”ย the authors of the new study noted.ย
โTherefore, our study aims to assess Vit D concentrations in older patients admitted to a geriatric ward and to evaluate the adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviours (i.e., taking vitamin D supplements) and whether the recommended, optimal 25 (OH) D concentration values are achieved.โ
Study detailsย โย
The study participants included 177 women and 63 men, 193 of whom were over the age of 75.ย Each patient underwent a comprehensive geriatric assessment, which included a detailed medical history, physical examination and laboratory tests.ย Nutritional status considered socio-demographic data, anthropometric parameters and Vit D concentration.
The researchers reported a median 25(OH)D concentration of 22.95 (IQR, 13.7โ33.0) ng/mL, with aย โprofound deficiencyโ (<10 ng/mL) in 15% of participants and inadequacy (<30 ng/mL) inย 67.5% of participants.
Only 18.3% of individuals took Vit D supplements pre-admission, and insufficiency was more prevalent in non-supplemented individuals (70.9% vs. 52.3%) and those with a BMI โฅ30 kg/m2 (76.2% vs. 59.2%).ย A logistic regression model showed that obese patients had over two times higher odds of Vit D inadequacy, as did non-supplemented individuals.
The high prevalence of Vit D deficiency and inadequacy in geriatric ward admissions highlights the urgent need for targeted interventions and enhanced education for older adults, caregivers and physicians to improve adherence to preventive supplementation practices, the researchers concluded.
โResearch on available Vit D supplements in the market is crucial, considering that only select preparations in Poland hold ‘drug’ status and meet quality standards,โ they added.ย
ย
Journal: Nutrientsโ
doi: doi.org/10.3390/nu16020193โ
โVitamin D Status among Patients Admitted to a Geriatric WardโAre Recommendations for Preventing Its Deficiency Effective Enough?โ
Authors: Maksymilian Adam Lech et al.
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