title: Vitamin D response of older people in residential aged care to sunlight-derived ultraviolet radiation.
abstract: The aim of this study was to determine the vitamin D response to sunlight ultraviolet radiation in older people. Increases in vitamin D depended on the season of exposure, but the changes were small. Natural sun exposure is not a practical intervention for vitamin D deficiency in this population.
  
  
  OBJECTIVE
  The purpose of this study is to measure the ultraviolet radiation (UVR) exposure of those in residential aged care in an earlier trial of sunlight exposure and to determine its effect on their vitamin D response.
  
  
  METHODS
  Attendance data, demographic, clinical and biochemical variables for 248 participants were used for a secondary analysis of a previous cluster randomized trial of sunlight exposure and falls. The ambient solar UV Index data were used to calculate the participants' UVR dose. Multiple linear regression was used to test if UVR exposure over 6 months, as measured by the standard erythemal dose (SED), was a predictor of vitamin D response, controlling for age, gender, BMI, calcium intake, baseline vitamin D and season of exposure.
  
  
  RESULTS
  The median 25-hydroxyvitamin D (25OHD) was 32.4 nmol/L at baseline and 34.6 nmol/L at 6 months (p = 0.35). The significant predictors of 25OHD at 6 months were UVR exposures in spring-summer (coefficient = 0.105, 95 % confidence interval (CI) 0.001-0.209, p = 0.05) and autumn-winter (coefficient = 0.056, 95 % CI 0.005-0.107, p = 0.03) and baseline vitamin D (adjusted coefficient = 0.594, 95 % CI 0.465-0.724, p = 0.00). In those starting sunlight sessions in spring, an increase of 1 unit in log SED was associated with 11 % increase in 25OHD.
  
  
  CONCLUSIONS
  Natural UVR exposure can increase 25OHD levels in older people in residential care, but depends on the season of exposure. However, due to inadequate sun exposure, 25OHD did not reach optimal levels. Nevertheless, where sun exposure is encouraged in this group, the focus for the start of exposure should be in the months of spring or autumn, as this timing was associated with a vitamin D response.
authors.affiliation: Sydney Medical School Northern, University of Sydney, Sydney, NSW, 2006, Australia, seeta.durvasula@sydney.edu.au.
authors.forename: Seeta
authors.initials: S
authors.lastname: Durvasula
authors.forename: Peter
authors.initials: P
authors.lastname: Gies
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Mason
authors.forename: Jian Sheng
authors.initials: JS
authors.lastname: Chen
authors.forename: Stuart
authors.initials: S
authors.lastname: Henderson
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Seibel
authors.forename: Philip N
authors.initials: PN
authors.lastname: Sambrook
authors.forename: Lynette M
authors.initials: LM
authors.lastname: March
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Cindy
authors.initials: C
authors.lastname: Kok
authors.forename: Monique
authors.initials: M
authors.lastname: Macara
authors.forename: Trevor R
authors.initials: TR
authors.lastname: Parmenter
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000369:Aged, 80 and over; D002118:Calcium; D005260:Female; D006801:Humans; D008297:Male; D011874:Radiometry; D013472:Sunlight; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000517:prevention & control*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium