Hypovitaminosis D in Delirium: a Retrospective Cross-sectional Study

Abstract

BackgroundAs vitamin D may have a neuroprotective effect, the authors studied the association of biomarkers of vitamin D status and delirium to see if low vitamin D status was common in delirium cases.MethodsBiochemical measures of vitamin D (25-hydroxyvitamin D [25-OHD]) and calcium metabolism were used in this retrospective cross-sectional analysis of adult in-patients with delirium, admitted at three Canadian academic hospitals from January 2011 to July 2012. Primary outcome was to determine estimates of the prevalence of hypovitaminosis D in this group in whom vitamin D was checked.ResultsSeventy-one (5.8%) out of 1,232 delirium inpatients had their vitamin D measured. Thirty-nine (55%) showed vitamin D insufficiency (25-OHD of 25-75 nmol/L) and 8 (11%) showed vitamin D deficiency (25-OHD < 25 nmol/L). Mean serum 25-OHD levels were lower in males (57.1±7.7 nmol/L) than in females (78.2±6.1 nmol/L), p = .01, even when controlled for age and season. Men were younger than the women (74.4±2.3 vs. 82.4±1.7, p = .005). Mean age was 78.7±1.5 years, and 33 (47%) were male.ConclusionsAlthough vitamin D is rarely checked during delirium workup and/or management, high rates of hypovitaminosis D were found to be common in the delirium in-patients in whom it was checked. Larger studies would be needed to estimate the prevalence of hypovitaminosis D in delirium and whether hypovitaminosis D plays a role in the pathogenesis of delirium.

Vitamin K1 and 25(OH)D are independently and synergistically associated with a risk for hip fracture in an elderly population: A case control study

“…Vitamin D receptors has been located in the human cortex and hippocampus, which are key areas for cognition and may regulate neurotransmission, neuroprotection and neuro immuno modulation including anti-inflammatory and antioxidant effects (90)(91)(92). This may explain our findings for vitamin D. A cross sectional study examined 25(OH)D in patients who experienced a delirium found a common hypovitaminosis D in delirious patients (150), and a pilot study of intensive care unit patients showed that low vitamin D was associated with delirium at borderline significance (148). However, Lapid et al studied hypovitaminosis D in a geriatric psychiatric ward and found no association between vitamin D and cognitive function including delirium, however only n= 13 patients with delirium were presented in this study (151).…”

Xenon for the prevention of postoperative delirium in cardiac surgery: study protocol for a randomized controlled clinical trial

“…Because of a possible correlation between preoperative vitamin D levels and the occurrence of POD, serum-levels of 25-hydroxy vitamin D (25-OHD) will be checked for all patients preoperatively [ 45 , 46 ]. Furthermore, different blood samples will be collected at baseline (visit 0), at 1 hour after end of surgery (visit 2) and postoperative day 1 (visit 3).…”

Vitamin D and Delirium in Older Adults: A Case-Control Study in Geriatric Acute Care Unit

“…Our results are in accordance with the scarce previous literature. Ford et al found hypovitaminosis D (ie, insufficiency <75 nmol/L or deficiency <25 nmol/L) in 66% of people diagnosed with delirium from three Canadian university hospitals (12). Similarly, in a cohort of more than 4,000 patients, Quraishi et al reported that serum 25OHD concentration <25 nmol/L prior to hospitalization was associated with an increased risk of delirium during the hospital stay (16), which suggested that the vitamin D status could be a changeable risk factor for delirium acquired during hospitalization.…”

“…Delirium is an acute neurocognitive disorder leading to greater morbidity (pressure ulcers, infectious diseases, fall risk, disability), complicated care course (prolonged hospital stays, more frequent readmissions, increased healthcare costs), and greater mid-term mortality ( 10 – 12 ). Pathophysiology of delirium remains not fully elucidated.…”