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.
  
  
  METHODS
  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 D₃ (25(OH)D₃) at baseline. Vital status of the subjects was ascertained and hazard ratios (HRs) for mortality according to 25(OH)D₃ 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)D₃ >48  nmol/l), HR (with 95% CI) for mortality was 2.02 (1.31-3.12) in Q1 (25(OH)D₃ <29  nmol/l) (P<0.05); 2.03 (1.32-3.14) in Q2 (25(OH)D₃ 30-37  nmol/l) (P<0.05) and 1.6 (1.03-2.48) in Q3 (25(OH)D₃ 38-47  nmol/l) (P<0.05). The mean 25(OH)D₃ concentration was 40.2  nmol/l (S.D. 16.0) and 80% had 25(OH)D₃ 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.
authors: Department of Medical and Health Sciences, Linköping University, SE-581 83 Linköping, Sweden.
authors: Maria
authors: M
authors: Samefors
authors: Carl Johan
authors: CJ
authors: Östgren
authors: Sigvard
authors: S
authors: Mölstad
authors: Christina
authors: C
authors: Lannering
authors: Patrik
authors: P
authors: Midlöv
authors: Anders
authors: A
authors: Tengblad
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002112:Calcifediol / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged; D006801:Humans; D015994:Incidence; D008297:Male; D009026:Mortality; D009735:Nursing Homes; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D002112:Calcifediol