Vitamin D deficiency increases hospitalisation risk in older population
Studies have revealed an association between vitamin D and conditions such as sepsis, exacerbation of chronic illnesses, and functional outcomes following falls and fractures. It has also been linked to a reduction in cardiovascular risk, inflammation, increased platelet volume, vascular stiffness and improved cognitive function.
Frailty is associated with increased hospital attendance and higher healthcare costs and an association has been found between vitamin D deficiency and frailty.
Prior studies have suggested that vitamin D deficiency is associated with increased risk of hospital re-admission, nursing home admission, and increased hospital LOS. Whereas some studies have shown an association between vitamin D and conditions leading to admission such as multiple sclerosis and Chronic Obstructive Pulmonary Disease (COPD), and infections.
The aim of the current study was to evaluate the relationship between serum vitamin D and emergency department attendance, hospital admission, and length of stay (LOS) in older Irish community-dwelling adults.
This is the first study to examine the association between vitamin D deficiency and hospitalisation, as opposed to specific diseases or illnesses, in a large population of older adults.
The analysis was conducted in 3093 participants aged 60 years and older recruited to the Trinity-Ulster, Department of Agriculture (TUDA) study through St James’s Hospital, Dublin.
It was a cross-sectional study designed to create a genotype/phenotype database for three population cohorts based on three disease states: cognition, bone health, and hypertension.
The reported results reveal an inverse relationship between vitamin D deficiency and emergency department attendance, hospital admission rate, and LOS.
Participants with concentrations of 25(OH)D < 50nmol/L were more likely to attend the ED and be admitted. This relationship remained robust in fully adjusted models accounting for multiple cofounders for vitamin D status, measures of physical and cognitive frailty, and for a number of chronic conditions.
Those participants with lower vitamin D who were admitted to hospital were also more likely to have longer LOS compared with vitamin-D-replete participants.
The report concludes: "This prospective association strengthens the need to consider vitamin D as an independent modifiable factor in ED attendance and hospital admission rates and the potential need for supplementation in older adults deficient in vitamin D to bring concentrations >50 nmol/L.
"The need for further evaluation of current recommendations in relation to vitamin D supplementation, with consideration of the effects of deficiency beyond bone health, is warranted and should focus on randomised controlled trials."
Source: Nutrients
Cunningham. C., et al
"Vitamin D and Hospital Admission in Older Adults: A Prospective Association"
