title: Seasonal variation, hip fracture and vitamin D levels in Southern Tasmania.
abstract: OBJECTIVE
  To determine the frequency of vitamin D deficiency in older patients admitted with a hip fracture and to look for seasonal variation in vitamin D levels and hip fracture in Southern Tasmania.
  
  
  METHODS
  This was a case series of patients admitted to the Royal Hobart Hospital, Tasmania with a hip fracture from July 1996-June 1997. Information was collected on demographic data, functional activity, associated medical disorders and drug history.
  
  
  RESULTS
  There were 91 patients, 66 female with a mean age of 81.3 years. Vitamin D deficiency, defined as a serum 1,25 hydroxyvitamin D level <28 nmol/L was present in 67% of subjects. Vitamin D levels were low throughout the year without significant seasonal variation. There was no seasonal variation in admissions with a hip fracture. The majority of patients (68%) either lived in institutional care or were dependent on a carer and 43% reported going outdoors less than once a week.
  
  
  CONCLUSIONS
  The high incidence of vitamin D deficiency in these subjects admitted with a hip fracture reflects reduced sunlight exposure and poor diet and is probably a marker of frailty. The absence of seasonal variation reflects a frailer population likely to be housebound, less mobile and more likely to have falls and sustain a fracture. Older and frailer people may benefit from routine screening for vitamin D deficiency, and replacement therapy should be considered for those found to be deficient.
authors.affiliation: Department of Geriatric Medicine, Royal Hobart Hospital, Tasmania. Charles.Inderjeeth@health.wa.gov.au
authors.forename: C A
authors.initials: CA
authors.lastname: Inderjeeth
authors.forename: T
authors.initials: T
authors.lastname: Barrett
authors.forename: Y
authors.initials: Y
authors.lastname: Al-Lahham
authors.forename: J
authors.initials: J
authors.lastname: Mulford
authors.forename: F
authors.initials: F
authors.lastname: Nicklason
authors.forename: C
authors.initials: C
authors.lastname: Reberger
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006299:Health Services for the Aged; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012621:Seasons; D013250:Steroid Hydroxylases / Q000097:blood*; D013648:Tasmania / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D013250:Steroid Hydroxylases; C406322:vitamin D 1-alpha hydroxylase