Vitamin D deficiency in elderly people in Swedish nursing homes is associated with increased mortality

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title = "Vitamin D deficiency in elderly people in Swedish nursing homes is associated with increased mortality",
abstract = "Objective: Institutionalised elderly people at northern latitudes may be at elevated risk for vitamin D deficiency. In addition to osteoporosis-related disorders, vitamin D deficiency may influence several medical conditions conferring an increased mortality risk. The aim of this study was to explore the prevalence of vitamin D deficiency and its association with mortality. Design: The Study of Health and Drugs in the Elderly (SHADES) is a prospective cohort study among elderly people (>65 years) in 11 nursing homes in Sweden. Methods: We analysed the levels of 25-hydroxyvitamin D-3 (25(OH)D-3) at baseline. Vital status of the subjects was ascertained and hazard ratios (HRs) for mortality according to 25(OH)D-3 quartiles were calculated. Results: We examined 333 study participants with a mean follow-up of 3 years. A total of 147 (44{\%}) patients died within this period. Compared with the subjects in Q4 (25(OH)D-3 >48 nmol/l), HR (with 95{\%} CI) for mortality was 2.02 (1.31-3.12) in Q1 (25(OH)D-3 <29 nmol/l) (P<0.05); 2.03 (1.32-3.14) in Q2 (25(OH)D-3 30-37 nmol/l) (P<0.05) and 1.6 (1.03-2.48) in Q3 (25(OH)D-3 38-47 nmol/l) (P<0.05). The mean 25(OH)D-3 concentration was 40.2 nmol/l (S.D. 16.0) and 80{\%} had 25(OH)D-3 below 50 nmol/l. The vitamin D levels decreased from baseline to the second and third measurements. Conclusions: Vitamin D deficiency was highly prevalent and associated with increased mortality among the elderly in Swedish nursing homes. Strategies are needed to prevent, and maybe treat, vitamin D deficiency in the elderly in nursing homes and the benefit of vitamin D supplementation should be evaluated in randomised clinical trials.",
author = "Maria Samefors and Ostgren, {Carl Johan} and Sigvard M{\"o}lstad and Christina Lannering and Patrik Midl{\"o}v and Anders Tengblad",
year = "2014",
doi = "10.1530/EJE-13-0855",
language = "English",
volume = "170",
pages = "667--675",
journal = "European Journal of Endocrinology",
issn = "1479-683X",
publisher = "Society of the European Journal of Endocrinology",
number = "5",