title: Older Swedish Adults with High Self-Perceived Health Show Optimal 25-Hydroxyvitamin D Levels Whereas Vitamin D Status Is Low in Patients with High Disease Burden.
abstract: Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH)D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH)D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people ≥75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy. Only 13% of the 169 controls were vitamin D deficient (S-25(OH)D) < 50 nmol/L), in contrast with 49% of orthopedic patients with hip fractures (n= 133), 31% of stroke patients (n= 122), 39% of patients visiting the hospital's emergency department ≥4 times a year (n= 81), and 75% of homebound adult residents in long-term care nursing homes (n= 51). The mean vitamin D concentration of the healthy control group (74 nmol/L) was similar to a suggested optimal level based on physiological data and mortality studies, and much higher than that of many officially recommended cut-off levels for vitamin D deficiency (<50 nmol/L). The present study provides a basis for planning and implementing public guidelines for the screening of vitamin D deficiency and vitamin D treatment for frail elderly patients.
authors.affiliation: Department of Clinical Chemistry, County Hospital of Kalmar, 391 85 Kalmar, Sweden. martin.carlsson@ltkalmar.se.|Department of Medicine and Optometry, Linnaeus University, 392 34 Kalmar, Sweden. martin.carlsson@ltkalmar.se.
authors.forename: Martin
authors.initials: M
authors.lastname: Carlsson
authors.affiliation: Section of Endocrinology, Department of Internal Medicine, County Hospital of Kalmar, 391 85 Kalmar, Sweden. par.wanby@ltkalmar.se.
authors.forename: Pär
authors.initials: P
authors.lastname: Wanby
authors.affiliation: Department Medical and Health Sciences, University of Linkoping, 581 83 Linköping, Sweden. lars.brudin@ltkalmar.se.|Department of Clinical Physiology, County Hospital, 391 85 Kalmar, Sweden. lars.brudin@ltkalmar.se.
authors.forename: Lars
authors.initials: L
authors.lastname: Brudin
authors.affiliation: Department of Psychiatry, County Hospital of Kalmar, 391 85 Kalmar, Sweden. erik.lexne@ltkalmar.se.
authors.forename: Erik
authors.initials: E
authors.lastname: Lexne
authors.affiliation: Department Geriatric Medicine, County Hospital of Kalmar, 391 85 Kalmar, Sweden. karin.mathold@ltkalmar.se.
authors.forename: Karin
authors.initials: K
authors.lastname: Mathold
authors.affiliation: Department of Orthopaedics, County Hospital of Kalmar, 391 85 Kalmar, Sweden. rebecca.nobin@ltkalmar.se.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nobin
authors.affiliation: Department of Medicine and Optometry, Linnaeus University, 392 34 Kalmar, Sweden. lisa.ericson@lnu.s.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ericson
authors.affiliation: The Pharmaceutical Department, Kalmar County Council, 392 44 Kalmar, Sweden. ola.nordqvist@ltkalmar.se.
authors.forename: Ola
authors.initials: O
authors.lastname: Nordqvist
authors.affiliation: Department of Medicine and Optometry, Linnaeus University, 392 34 Kalmar, Sweden. goran.petersson@lnu.se.
authors.forename: Göran
authors.initials: G
authors.lastname: Petersson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001782:Blood Donors; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010024:Osteoporosis / Q000097:blood; D012621:Seasons; D012649:Self Concept; D020521:Stroke / Q000097:blood; D013548:Sweden / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: 25-hydroxyvitamin D; Sweden; emergency care; frail older adult; vitamin D