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Majority of frail hospital patients had low vitamin D, which did not change with season – 2018

Seasonal Variation in Vitamin D Status among Frail Older Hospitalized Patients.

J Frailty Aging. 2018;7(2):95-99. doi: 10.14283/jfa.2018.10.
Pourhassan M1, Wirth R.
Maryam Pourhassan, Department of Geriatric Medicine, Marien Hospital Herne, University Hospital, Ruhr-University Bochum, Germany, Hölkeskampring 40, D-44625 Herne, Germany, Tel: 023255937, Fax: 02323 - 499 - 3387, Email: maryam.pourhassan at ruhr-uni-bochum.de.

Vitamin D Life

10 reasons why seniors need more vitamin D has the following

  1. Senior skin produces 3X less Vitamin D for the same sun intensity
  2. Seniors have fewer vitamin D receptors as they age
    (The effect of low Vitamin D receptor genes does not show up on vitamin D test results)
  3. Seniors are indoors more than when when they were younger
    not as agile, weaker muscles; frail, no longer enjoy hot temperatures
    (if outside, stay in the shade), however, seniors might start outdoor activities like gardening, biking, etc.
  4. Seniors wear more clothing outdoors than when younger
    fear skin cancer/wrinkles, sometimes avoid bright light after cataract surgery
  5. Seniors often take various drugs which reduce vitamin D (some would not show up on vitamin D test) statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc
  6. Seniors often have one or more diseases which consume vitamin D ( osteoporosis, diabetes, MS, ...)
  7. Seniors generally put on weight at they age - and a heavier body requires more vitamin D
  8. Seniors often (40%) have fatty livers – which do not process vitamin D as well
  9. Seniors not have as much Magnesium needed to use vitamin D
    (would not show up on vitamin D test)
  10. Seniors with poorly functioning kidneys do not process vitamin D as well
    (would not show up on vitamin D test) 2009 full text online  Also PDF 2009
  11. Vitamin D is not as bioavailable in senior digestive systems (Stomach acid or intestines?)


BACKGROUND AND OBJECTIVES:
Seasonal variation in 25-hydroxyvitamin D [25(OH)D] levels is the result of sunlight dependent skin synthesis of vitamin D. However, its presence is not studied in frail older hospitalized patients. We sought to investigate whether seasonal variation in 25(OH)D levels is evident among these patients.

DESIGN AND SETTING:
This study investigated older participants who were consecutively admitted between February 2015 and December 2016 to the geriatric acute care ward. Results of routine measurements of 25(OH)D at hospital admission were retrospectively analyzed and stratified according to months and seasons. Previous intake of vitamin D supplementation was derived from the patients' medical records.

RESULTS:
The study group comprised 679 participants (mean age 82.1±8.2; 457 females), of which 78% had vitamin D deficiency. Older individuals not taking vitamin D supplements had a lower mean serum 25(OH)D than those receiving supplements. Of those patients with no vitamin D supplementation, 87.0% were vitamin D deficient and only 5% showing sufficient vitamin 25(OH)D. Further, there were neither monthly nor seasonal variations in vitamin 25(OH)D levels among these patients and their vitamin D levels stayed far below the recommended threshold of 20 ng/ml across the seasons.

CONCLUSION:
Vitamin D deficiency was very prevalent in the subgroup of older hospitalized patients without vitamin D supplementation, irrespective of season. Since no seasonal variations in mean 25(OH)D levels was observed, sunlight dependent skin synthesis is unlikely to contribute to vitamin D status in these patients. Supplementation seems to be necessary to maintain desirable vitamin D levels among this population throughout the year.


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