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Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents.
BMC Geriatr 2017; 17(1):229BG

Abstract

BACKGROUND

Residents of nursing homes may have low 25-hydroxyvitamin D (25OHD) concentrations. Associations between vitamin D and cognitive performance, dementia and susceptibility to infections are not clearly established. The aim of this study was to investigate the prevalence of vitamin D deficiency and to identify associated factors among residents of nursing homes for elderly.

METHODS

In this cross-sectional study blood samples for analysis of 25OHD were collected from all participating residents of Swedish nursing homes for the elderly from January to March 2012.

EXCLUSION CRITERIA

dementia too severe to collect a blood test, terminally ill or refusing participation.

OUTCOME MEASURES

Serum 25OHD concentrations. Logistic regression to evaluate factors associated with vitamin D deficiency (25OHD < 25 nmol/L).

RESULTS

Blood samples were obtained from 545 of 901 residents of 22 nursing homes. Mean age 86 years (SD 6.9), 68% were women. Prevalence of vitamin D supplementation 17%, dementia 55%, lack of appetite ≥3 months 45% and any antibiotic treatment during the last 6 months 30%. Serum 25OHD concentrations: mean 34 nmol/L (SD 21, median 27, range 4-125), 82% (448/545) had 25OHD < 50 nmol/L and 41% (224/545) had 25OHD < 25 nmol/L. Adjusted OR (95% CI; p-value) for possible predictors of vitamin D deficiency (25OHD < 25 nmol/L): vitamin D supplementation 0.075 (0.031-0.18; p < 0.001), lack of appetite ≥3 months 0.75 (0.50-1.1; p = 0.15), hours outdoors/week 0.99 (0.96-1.0; p = 0.62), Fitzpatrick skin phototype (4-6) 0.69 (0.44-1.1; p = 0.12); dementia 2.3 (1.5-3.4; p < 0.001) and antibiotics last 6 months 1.6 (1.1-2.6; p < 0.029), adjusted for age and gender.

CONCLUSIONS

Vitamin D deficiency was common among nursing home residents and strongly associated with dementia. Regardless of causality or not, it is important to be alert for vitamin D deficiency in nursing homes residents with dementia. As expected vitamin D supplementation was associated with less vitamin D deficiency, however lack of appetite, staying outdoors and skin phototype were not significant predictors. Antibiotic treatments during the last 6 months were associated with vitamin D deficiency, potentially supporting the hypothesis that vitamin D deficiency is associated with infections.

Authors+Show Affiliations

Närhälsan, Research and Development Primary Health Care, Region Västra Götaland, Research and Development Center Södra Älvsborg Sweden, Sven Eriksonsplatsen 4, SE-503 38, Borås, Sweden. rebeka.arnljots@vgregion.se. Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Box 454, SE-405 30, Gothenburg, Sweden. rebeka.arnljots@vgregion.se. Närhälsan Heimdal Health Care Center, Stengärdsgatan 22, SE-503 34, Borås, Sweden. rebeka.arnljots@vgregion.se.Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Box 454, SE-405 30, Gothenburg, Sweden.Head Nurse, Health Care Unit Borås Municipality, Ramnåsgatan 1, SE-501 80, Borås, Sweden.Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK.Närhälsan, Research and Development Primary Health Care, Region Västra Götaland, Research and Development Center Södra Älvsborg Sweden, Sven Eriksonsplatsen 4, SE-503 38, Borås, Sweden. Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Box 454, SE-405 30, Gothenburg, Sweden. Närhälsan Sandared Health Care Center, Strandvägen 11, SE-518 32, Sandared, Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29017462

Citation

Arnljots, Rebeka, et al. "Vitamin D Deficiency Was Common Among Nursing Home Residents and Associated With Dementia: a Cross Sectional Study of 545 Swedish Nursing Home Residents." BMC Geriatrics, vol. 17, no. 1, 2017, p. 229.
Arnljots R, Thorn J, Elm M, et al. Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents. BMC Geriatr. 2017;17(1):229.
Arnljots, R., Thorn, J., Elm, M., Moore, M., & Sundvall, P. D. (2017). Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents. BMC Geriatrics, 17(1), p. 229. doi:10.1186/s12877-017-0622-1.
Arnljots R, et al. Vitamin D Deficiency Was Common Among Nursing Home Residents and Associated With Dementia: a Cross Sectional Study of 545 Swedish Nursing Home Residents. BMC Geriatr. 2017 10 10;17(1):229. PubMed PMID: 29017462.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents. AU - Arnljots,Rebeka, AU - Thorn,Jörgen, AU - Elm,Marie, AU - Moore,Michael, AU - Sundvall,Pär-Daniel, Y1 - 2017/10/10/ PY - 2017/06/16/received PY - 2017/10/02/accepted PY - 2017/10/12/entrez PY - 2017/10/12/pubmed PY - 2018/4/19/medline KW - Antibiotics KW - Dementia KW - Frail elderly KW - Homes for the aged KW - Infectious disease KW - Nursing homes KW - Vitamin D SP - 229 EP - 229 JF - BMC geriatrics JO - BMC Geriatr VL - 17 IS - 1 N2 - BACKGROUND: Residents of nursing homes may have low 25-hydroxyvitamin D (25OHD) concentrations. Associations between vitamin D and cognitive performance, dementia and susceptibility to infections are not clearly established. The aim of this study was to investigate the prevalence of vitamin D deficiency and to identify associated factors among residents of nursing homes for elderly. METHODS: In this cross-sectional study blood samples for analysis of 25OHD were collected from all participating residents of Swedish nursing homes for the elderly from January to March 2012. EXCLUSION CRITERIA: dementia too severe to collect a blood test, terminally ill or refusing participation. OUTCOME MEASURES: Serum 25OHD concentrations. Logistic regression to evaluate factors associated with vitamin D deficiency (25OHD < 25 nmol/L). RESULTS: Blood samples were obtained from 545 of 901 residents of 22 nursing homes. Mean age 86 years (SD 6.9), 68% were women. Prevalence of vitamin D supplementation 17%, dementia 55%, lack of appetite ≥3 months 45% and any antibiotic treatment during the last 6 months 30%. Serum 25OHD concentrations: mean 34 nmol/L (SD 21, median 27, range 4-125), 82% (448/545) had 25OHD < 50 nmol/L and 41% (224/545) had 25OHD < 25 nmol/L. Adjusted OR (95% CI; p-value) for possible predictors of vitamin D deficiency (25OHD < 25 nmol/L): vitamin D supplementation 0.075 (0.031-0.18; p < 0.001), lack of appetite ≥3 months 0.75 (0.50-1.1; p = 0.15), hours outdoors/week 0.99 (0.96-1.0; p = 0.62), Fitzpatrick skin phototype (4-6) 0.69 (0.44-1.1; p = 0.12); dementia 2.3 (1.5-3.4; p < 0.001) and antibiotics last 6 months 1.6 (1.1-2.6; p < 0.029), adjusted for age and gender. CONCLUSIONS: Vitamin D deficiency was common among nursing home residents and strongly associated with dementia. Regardless of causality or not, it is important to be alert for vitamin D deficiency in nursing homes residents with dementia. As expected vitamin D supplementation was associated with less vitamin D deficiency, however lack of appetite, staying outdoors and skin phototype were not significant predictors. Antibiotic treatments during the last 6 months were associated with vitamin D deficiency, potentially supporting the hypothesis that vitamin D deficiency is associated with infections. SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/29017462/Vitamin_D_deficiency_was_common_among_nursing_home_residents_and_associated_with_dementia:_a_cross_sectional_study_of_545_Swedish_nursing_home_residents_ L2 - https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-017-0622-1 DB - PRIME DP - Unbound Medicine ER -