Clinical Identification of Geriatric Patients with Hypovitaminosis D: The ‘Vitamin D Status Predictor for Geriatrics’ Study

Abstract

The 16-item Vitamin D Status Predictor (VDSP) tool identifies healthy older community-dwellers at risk of hypovitaminosis D and may guide the use of blood tests in this population. The objective of the present hospital-based study was to test the efficacy of the VDSP to identify geriatric patients with hypovitaminosis D. The study included 199 nonsupplemented geriatric in- and outpatients consecutively admitted to Angers University Hospital, France (mean ± SD, 82.0 ± 7.8 years; 53.3% female). Serum 25-hydroxyvitaminD (25(OH)D) was measured at the time of the physician-administered VDSP. Hypovitaminosis D was defined as serum 25(OH)D concentration ≤ 75 nmol/L for vitamin D insufficiency, 25(OH)D ≤ 50 nmol/L for vitamin D deficiency, and 25(OH)D ≤ 25 nmol/L for severe vitamin D deficiency. We found that 184 participants (92.4%) had vitamin D insufficiency, 136 (68.3%) had vitamin D deficiency, and 67 (33.7%) had severe vitamin D deficiency. The VDSP identified severe vitamin D deficiency with an area under curve (AUC) = 0.83 and OR = 24.0. The VDSP was able to identify vitamin D deficiency and vitamin D insufficiency with less accuracy (AUC = 0.71 and AUC = 0.73, respectively). In conclusion, the 16-item VDSP is a short questionnaire that accurately identifies geriatric patients with severe vitamin D deficiency. This tool may guide the use of blood collection for determining geriatric patients’ vitamin D status.

Vitamin D deficiency in elderly: Risk factors and drugs impact on vitamin D status

“…This result seems to be inconsistent with the findings of some previous studies. [ 56 ],[ 57 ],[ 58 ],[ 59 ],[ 60 ] These studies have reported that the low 25(OH)D levels in the elderly were seen more commonly in women compared to men.…”

Prevalence of Vitamin D Deficiency in Patients With Talar Osteochondral Lesions

“…The rate of hypovitaminosis D in the elderly is known to be even higher than the general population. 2,34 Fortunately, when patients are actively treated for vitamin D deficiency (even those with metabolic bone disease), the rate of vitamin D deficiency is much lower (4.6%), 4 demonstrating that concerted intervention can be effective. 6 Even better, preventive measures could help decrease the burden of fragility fractures for patients and society alike.…”

Self-administered Vitamin D Status Predictor: Older adults are able to use a self-questionnaire for evaluating their vitamin D status

“…We studied in- and outpatients aged 65 and over consecutively recruited in the VDSP-G (Vitamin D Status Predictor for Geriatrics) study. The VDSP-G study is an observational cross-sectional study designed to apply the VDSP among all patients consecutively hospitalized or seen in consultation in the geriatric acute care unit of the University Hospital of Angers, France, from March to May 2015 [ 14 ]. After giving their written informed consent for research, included participants received a full medical examination consisting of a self-administered VDSP questionnaire, various rater-administered structured questionnaires and a standardized clinical examination.…”

“…Finally, the algorithms previously published [ 13 ] were applied to the items of the self-VDSP to identify among participants those with probable severe vitamin D deficiency (i.e., serum 25(OH)D ≤25nmol/L), vitamin D deficiency (i.e., serum 25(OH)D ≤50nmol/L) or vitamin D insufficiency (i.e., serum 25(OH)D ≤75nmol/L) [ 1 ]. Briefly, the VDSP is based on a 16-item questionnaire coupled with combinatorial non-linear algorithms that were built from models of feed forward artificial neural networks (multilayer perceptron) [ 13 , 14 ]. In practice, clinicians submit the 16 responses to the tool, which combines them using three dedicated algorithms to identify severe vitamin D deficiency, deficiency or insufficiency.…”

“…To avoid the need for a blood test screening for vitamin D status in older adults, we recently developed the Vitamin D Status Predictor (VDSP), a 16-item questionnaire able to identify older adults with undesirable vitamin D status who may be administered vitamin D supplements without obtaining a blood test for 25(OH)D [ 13 , 14 ].…”