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Nutrients. 2016 Nov 11;8(11). pii: E717.

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.

Author information

1
Department of Clinical Chemistry, County Hospital of Kalmar, 391 85 Kalmar, Sweden. martin.carlsson@ltkalmar.se.
2
Department of Medicine and Optometry, Linnaeus University, 392 34 Kalmar, Sweden. martin.carlsson@ltkalmar.se.
3
Section of Endocrinology, Department of Internal Medicine, County Hospital of Kalmar, 391 85 Kalmar, Sweden. par.wanby@ltkalmar.se.
4
Department Medical and Health Sciences, University of Linkoping, 581 83 Linköping, Sweden. lars.brudin@ltkalmar.se.
5
Department of Clinical Physiology, County Hospital, 391 85 Kalmar, Sweden. lars.brudin@ltkalmar.se.
6
Department of Psychiatry, County Hospital of Kalmar, 391 85 Kalmar, Sweden. erik.lexne@ltkalmar.se.
7
Department Geriatric Medicine, County Hospital of Kalmar, 391 85 Kalmar, Sweden. karin.mathold@ltkalmar.se.
8
Department of Orthopaedics, County Hospital of Kalmar, 391 85 Kalmar, Sweden. rebecca.nobin@ltkalmar.se.
9
Department of Medicine and Optometry, Linnaeus University, 392 34 Kalmar, Sweden. lisa.ericson@lnu.s.
10
The Pharmaceutical Department, Kalmar County Council, 392 44 Kalmar, Sweden. ola.nordqvist@ltkalmar.se.
11
Department of Medicine and Optometry, Linnaeus University, 392 34 Kalmar, Sweden. goran.petersson@lnu.se.

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.

KEYWORDS:

25-hydroxyvitamin D; Sweden; emergency care; frail older adult; vitamin D

PMID:
27845703
PMCID:
PMC5133103
DOI:
10.3390/nu8110717
[Indexed for MEDLINE]
Free PMC Article

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