The Prevalence of Vitamin D Deficiency and the Determinants of 25(OH)D Concentration in Older Irish Adults: Data From The Irish Longitudinal Study on Ageing (TILDA)

Laird, Éamon; O’Halloran, Aisling; Carey, Daniel; Healy, Martin; O’Connor, Deirdre; Moore, Patrick; Shannon, Tom; Molloy, Anne M.; Kenny, Rose Anne

doi:10.1093/gerona/glx168

Cited by 80 publications

(113 citation statements)

References 31 publications

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“…Another weakness of this study was that it was carried out in a group of Crohn's disease patients, which might not be representative of the general population limiting the generalizability of the findings. 25(OH)D concentrations we observed are comparable to what was previously reported for the general population in Ireland although it is thought that the prevalence of deficiency might be higher in Crohn's disease, due to reduced dietary vitamin D, reduced absorption of vitamin D or sun avoidance . Additionally, this study was carried out at one location, and therefore, there was little geographical variability (73% of participants were from the same D‐UVB grid); therefore, most of the variation in UVB levels was temporal, due to different times of blood draw.…”

Section: Discussionsupporting

confidence: 80%

Sunshine is an Important Determinant of Vitamin D Status Even Among High‐dose Supplement Users: Secondary Analysis of a Randomized Controlled Trial in Crohn's Disease Patients

O’Sullivan

Raftery

Weele

et al. 2019

Photochem & Photobiology

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Sunshine is considered to be the most important source of vitamin D. Due to an increased risk of skin cancer, sun avoidance is advised, but this directly contributes to the high prevalence of vitamin D deficiency. The simple solution is to advise vitamin D supplementation. The aim of this study was to examine the absolute and relative contribution of sunshine and supplementation to vitamin status. This study was a secondary analysis of an RCT of 92 Crohn's disease patients in remission (49% female, median age = 44). Participants were randomized to 2000 IU day À1 of vitamin D3 or placebo for 1 year, with 25-hydroxyvitamin D (25(OH)D) being measured at baseline and every 4 months. Based on participant's place of residence, daily ambient UVB dose at wavelengths that can induce vitamin D synthesis (D-UVB) was obtained. Cumulative and weighted ambient D-UVB (cw-D-UVB) exposure prior to each blood draw was calculated for each participant. Linear regression analysis and multilevel modeling were used to examine the association between UVB exposure, supplementation and 25(OH)D concentration. There was considerable annual variation in D-UVB, cw-D-UVB and 25(OH) D. Both supplementation and cw-D-UVB were found to be strongly associated with 25(OH)D: in multilevel model, an increase of approximately 6 nmol L À1 for every 100 kJ m À2 in cw-D-UVB was found, among those receiving placebo and supplementation (P < 0.0001). Treatment was associated with increase of 23 nmol L À1 (P < 0.0001). Sunshine is an important determinant of 25(OH)D concentration, even in those who are taking high-dose vitamin D supplements and reside at a higher mid-latitude location.Abbreviations: 25(OH)D, 25-hydroxyvitamin D; cw-D-UVB,

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Section: Discussionsupporting

confidence: 80%

Sunshine is an Important Determinant of Vitamin D Status Even Among High‐dose Supplement Users: Secondary Analysis of a Randomized Controlled Trial in Crohn's Disease Patients

O’Sullivan

Raftery

Weele

et al. 2019

Photochem & Photobiology

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“…In this COPD patient cohort, the seasonal variation in 25(OH)D concentrations observed mirror those recently reported in the general healthy older Irish population in The Irish Longitudinal Study on Aging (TILDA),35 although at concentrations ~10–20 nmol/L lower than the healthy cohort. The current findings are comparable to those from other European COPD cohorts 4,32.…”

Section: Discussionsupporting

confidence: 80%

Vitamin D status is associated with muscle strength and quality of life in patients with COPD: a seasonal prospective observation study

Carson¹,

Pourshahidi²,

Madigan³

et al. 2018

COPD

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BackgroundOwing to hospitalization, reduced functional capacity and consequently, less sunlight exposure, suboptimal vitamin D status (25-hydroxyvitamin D [25(OH)D]⩽50 nmol/L) is prevalent among COPD patients.ObjectiveThis study aimed to investigate seasonal changes in vitamin D status and any associated changes in fat-free mass (FFM), muscle strength and quality of life (QoL) in COPD patients.Patients and methodsCOPD patients living in Northern Ireland (n=51) completed study visits at the end of winter (March/April) and at the end of summer (September/October), corresponding to the nadir and peak of vitamin D status, respectively. At both time points, serum concentration of 25(OH)D was quantified by liquid chromatography-tandem mass spectrometry, FFM (kg) was measured using bioelectrical impedance and muscle strength (kg) was measured using handgrip dynamometry. QoL was assessed using the validated St George’s Respiratory Questionnaire.ResultsMean±SD 25(OH)D concentration was significantly higher at the end of summer compared to the end of winter (52.5±30.5 nmol/L vs 33.7±28.4 nmol/L, P<0.001); and house- bound patients had significantly lower 25(OH)D concentration compared to nonhousebound patients at the end of summer (42.9±4.2 vs 57.2±9.9 nmol/L; P⩽0.001). Muscle strength (at both time points) and QoL (end of summer only) were positively predicted by 25(OH)D concentration, independent of age, sex and smoking status.ConclusionThis study highlights the need for health policies to include a recommendation for year-round vitamin D supplementation in housebound COPD patients, and wintertime supplementation in nonhousebound patients, to maintain optimal 25(OH)D concentrations to protect musculoskeletal health. Furthermore, an optimal vitamin D status may have potential benefits for QoL in these patients.

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“…64 We provide evidence for an association with prefrailty, which is less well reported. Vitamin D insufficiency affects 40% of older Irish adults 54 and is implicated in the risk of negative outcomes for musculoskeletal health and falls prevention. 32,66 Vitamin D levels among older adults are negatively impacted by reductions in UVB exposure, endogenous synthesis, dietary intake, and age-related malabsorption.…”

Section: Discussionmentioning

confidence: 99%

Circulating Micronutrient Biomarkers Are Associated With 3 Measures of Frailty: Evidence From the Irish Longitudinal Study on Ageing

O’Halloran

Laird

Feeney

et al. 2020

Journal of the American Medical Directors Association

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Keywords:Micronutrients biomarkers frailty aging a b s t r a c t Objectives: To examine the associations between 3 frailty instruments and circulating micronutrients in a large representative sample of older adults. Design: Cross-sectional data from a nationally representative cohort study conducted between October 2009 and July 2011. Participants and setting: Adults age !50 years (n ¼ 4068) living in the community in Ireland. Measurements: Circulating micronutrients (lutein, zeaxanthin, folate, vitamin B-12, and vitamin D) were measured, transformed, and standardized. Frailty was assessed using the Frailty Phenotype, the Frailty Index, and the FRAIL Scale (fatigue, resistance, ambulation, illnesses, and loss of weight), instruments. Multinomial logistic regression determined associations between micronutrients and prefrailty or frailty. Models were adjusted for sociodemographic, lifestyle, health, and seasonal factors. Results: Adjusting for age, sex, and educational attainment, all 3 measures of frailty were associated with lower levels of lutein [relative risk ratios (RRRs): 0.43-0.63], zeaxanthin (RRRs: 0.49-0.63), and vitamin D (RRRs: 0.51-0.75), and with the accumulation of micronutrient insufficiencies (RRRs: 1.42-1.90). Attenuated but significant associations were also observed with all measures of prefrailty for lutein, vitamin D, and number of micronutrient insufficiencies. The associations with frailty persisted following additional adjustment for social, lifestyle, and health and seasonal factors, and following multiple test correction. Conclusions and implications:We have presented the most consistent evidence in the largest study to date that micronutrient concentrations are associated with prefrailty and frailty in older adults. Our data suggest that low micronutrient status has potential as an easily modifiable marker and intervention target for frailty and supports further investigation into micronutrient supplementation and fortification to prevent frailty and disability among older adults.

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The Prevalence of Vitamin D Deficiency and the Determinants of 25(OH)D Concentration in Older Irish Adults: Data From The Irish Longitudinal Study on Ageing (TILDA)

Abstract: Vitamin D deficiency is common among older Irish adults. These data indicate the need for targeted strategies within sections of the older population to improve vitamin D status.

Cited by 80 publications

References 31 publications

Sunshine is an Important Determinant of Vitamin D Status Even Among High‐dose Supplement Users: Secondary Analysis of a Randomized Controlled Trial in Crohn's Disease Patients

Sunshine is an Important Determinant of Vitamin D Status Even Among High‐dose Supplement Users: Secondary Analysis of a Randomized Controlled Trial in Crohn's Disease Patients

Vitamin D status is associated with muscle strength and quality of life in patients with COPD: a seasonal prospective observation study

Circulating Micronutrient Biomarkers Are Associated With 3 Measures of Frailty: Evidence From the Irish Longitudinal Study on Ageing

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