Vitamin D and Bone Health of Older Adults within Care Homes: An Observational Study

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Limited studies have reported vitamin D status and health outcomes in care home residents, a group at risk of vitamin D deficiency. This study investigated serum 25-hydroxyvitamin D (25-OHD) concentrations in older adults within care homes in Northern Ireland (NI) and its association with musculoskeletal health (ultrasound T-score, muscle strength, Timed Up & Go test (TUG)), bone turnover markers (BTMs), and immune function markers. A total of 87 participants were recruited with mean ± SD age 83.2 ± 7.9 years. Mean ± SD serum 25-OHD concentration (n 69) was 49.52 ± 35.58 nmol/L. Vitamin D deficiency (25-OHD <25 nmol/L) was observed in 34.8% (n 24) of participants with 17.4% (n 12) classified as insufficient (25-OHD 25-50 nmol/L) and 47.8% (n 33) as sufficient (25-OHD >50 nmol/L). 25-OHD concentration was not an independent predictor of T-score, muscle strength, TUG, or inflammatory cytokines. After adjusting for covariates, a significant negative association was observed between 25-OHD concentration and the BTMs; osteocalcin (β = -0.395; p = 0.001), procollagen type 1 N propeptide (P1NP) (β = -0.320; p = 0.012), and C-terminal telopeptide of type 1 collagen (CTX) (β = -0.377; p = 0.003). Higher 25-OHD concentration was positively associated with use of vitamin D ± calcium supplementation (β = 0.610; p < 0.001). Vitamin D deficiency and insufficiency were highly prevalent in this sample of care home residents in NI. Higher 25-OHD concentration was associated with greater supplement use and with reduced bone turnover, which in this population is linked with reduced bone loss. These findings emphasize the need for a mandatory vitamin D ± calcium supplementation policy specific for care home residents.
Original languageEnglish
Article number2680
Pages (from-to)1-15
Number of pages15
Issue number13
Early online date28 Jun 2022
Publication statusPublished (in print/issue) - 1 Jul 2022

Bibliographical note

Funding Information:
Conflicts of Interest: McSorley, Magee, and Pourshahidi reported a grant from BetterYou Ltd., outside the work submitted. Pourshahidi reported a grant from Devenish Nutrition Ltd., outside the work submitted. Professor Armstrong reported Royal Osteoporosis Society (advisory board), National Osteoporosis Guideline Group (advisory board), personal fees from Internis Pharma (speaker), UCB Pharma (advisory board), and stock ownership (GlaxoSmithKline), outside of the work submitted.

Funding Information:
Funding: This project was supported by PhD funding received from the Department for the Economy.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • vitamin D supplementation
  • nursing home
  • osteoporosis
  • vitamin D deficiency
  • aged
  • 80 and over
  • Bone Density
  • Calcium
  • Humans
  • Vitamin D Deficiency
  • Collagen Type I
  • Vitamin D Supplementation
  • Nursing Home
  • Vitamins
  • Osteoporosis
  • Vitamin D
  • Aged, 80 and over
  • Biomarkers
  • Bone Density/physiology
  • Vitamin D Deficiency/epidemiology


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