Older Swedish Adults with High Self-Perceived Health Show Optimal 25-Hydroxyvitamin D Levels Whereas Vitamin D Status Is Low in Patients with High Disease Burden

Abstract

Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH)D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH)D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people ≥75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy. Only 13% of the 169 controls were vitamin D deficient (S-25(OH)D) < 50 nmol/L), in contrast with 49% of orthopedic patients with hip fractures (n = 133), 31% of stroke patients (n = 122), 39% of patients visiting the hospital’s emergency department ≥4 times a year (n = 81), and 75% of homebound adult residents in long-term care nursing homes (n = 51). The mean vitamin D concentration of the healthy control group (74 nmol/L) was similar to a suggested optimal level based on physiological data and mortality studies, and much higher than that of many officially recommended cut-off levels for vitamin D deficiency (<50 nmol/L). The present study provides a basis for planning and implementing public guidelines for the screening of vitamin D deficiency and vitamin D treatment for frail elderly patients.

25-Hydroxyvitamin D in Cancer Patients Admitted to Palliative Care: A Post-Hoc Analysis of the Swedish Trial ‘Palliative-D’

“…In comparison with other Swedish cohorts with cross-sectional data on 25-OHD, our cohort of severely diseased patients had higher 25-OHD values compared to comparatively older Swedish nursing home residents [34,39,51], however values were lower than in healthy elderly [39]. We also observed significantly less seasonal variation in 25-OHD levels compared to healthy (and younger) Swedish cohorts [29,31].…”

“…In institutionalized patients in Swedish care homes, most patients were vitamin D deficient [34,35]. In contrast, community-dwelling elderly Swedes have much higher vitamin D levels [36][37][38][39]. In Supplementary Materials Table S1, we present cross sectional Swedish studies on 25-OHD levels.…”

Alterations in bone turnover markers in patients with noncardio-embolic ischemic stroke

“…The current study is part of a larger study regarding serum levels of vitamin D in patient populations at risk for vitamin D deficiency [9]. All participants were from the same geographical area (Kalmar County in southeastern Sweden).…”

<p>Adherence to risk management guidelines for drugs which cause vitamin D deficiency &ndash; big data from the Swedish health system</p>

“…Ever since, there has been a strong interest in exploring risk factors associated with low levels of vitamin D. Several recent cross-sectional studies have described the correlation between prescribed medications and vitamin D deficiency. In these studies, the number of prescribed drugs, as well as the use of certain pharmaceutical groups/substances, was associated with low levels of vitamin D 2–4…”