New research from Hawaii has found that vitamin D deficiency is linked to inability to complete daily tasks in the senior home setting.
Vitamin D deficiency is common among elderly living in nursing homes. In this setting, vitamin D deficiency has been linked to increased risk of falls and fractures, increased medical costs and increased risk of death.
While past research has looked at vitamin D levels among residents of nursing homes, none have looked at vitamin D status at time of admission.
This prompted researchers in the current study to ask, are male veterans vitamin D deficient at time of admission to the nursing home, and how does it affect their functional status?
They analyzed charts of 104 male veterans at the Veterans Affairs Pacific Islands Health Care System Community Living Center in Honolulu, Hawaii. They collected data on BMI, reason for admission, place where participant came from, hospital length of stay if from a hospital, chronic disease, and other factors.
They looked at vitamin D levels and vitamin D deficiency rates using levels less than 20 ng/ml as the definition of deficiency.
They also evaluated functional status using Katz activities daily living scale (ADLs), which is a method of assessing ability to complete 6 daily activities: bathing, dressing, toileting, transferring, continence, and feeding. The lower the ADL score, the more functional the person.
Overall, they found that the mean vitamin D level was 21 ng/ml and that 49% of participants were deficient. There was no significant association between vitamin D deficiency and reason for admission.
There was, however, an association between deficiency and length of stay in a hospital prior to admittance. Those who were hospitalized for more than 60 days had mean vitamin D levels of 13.4 ng/ml compared to 21.7 ng/ml in those with shorter hospitalization.
After evaluating for ADL disabilities, the researchers found that those with vitamin D deficiency had significantly more disabilities with a score of 3.7 versus 2.8 for those not deficient. More specifically, disabilities in mobility, dressing, toileting, and feeding were significantly more common in those with vitamin D deficiency compared to those not deficient.
The researchers noted some limitations of their study. They pointed out that their small sample size could have led to a lack of power to reach statistical significance for some factors. Additionally, since they were only looking at male veterans, their results cannot be generalized to larger populations. Finally, because of the cross-sectional study design, they couldn’t confirm causality.
The researchers call for future studies looking at vitamin D status at time of admission and the effects of subsequent vitamin D supplementation on falls, fractures, adverse reactions, and cost effectiveness.
“More ADL disabilities, disability in feeding, and prevalent diabetes mellitus were independently associated with higher risk of vitamin D deficiency,” the researchers concluded. “Considering that vitamin D supplementation is inexpensive, easy, and well tolerated, these high-risk nursing home residents might benefit from targeted screening for their vitamin D status on admission and treatment with supplementation as appropriate.”