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

Orlagh Feehan; David J Armstrong; Pamela J Magee; Kirsty L Pourshahidi; J J Strain; Laura Beggan; Diego F Cobice; Emeir M McSorley

doi:10.3390/nu14132680

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

Altnagelvin Hospital

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9 Citations (Scopus)

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Abstract

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 language	English
Article number	2680
Pages (from-to)	1-15
Number of pages	15
Journal	Nutrients
Volume	14
Issue number	13
Early online date	28 Jun 2022
DOIs	https://doi.org/10.3390/nu14132680
Publication status	Published (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.

Funding

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.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

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

Access to Document

10.3390/nu14132680Licence: CC BY

nutrients-14-02680Final published version, 868 KBLicence: CC BY

Cite this

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title = "Vitamin D and Bone Health of Older Adults within Care Homes: An Observational Study",

abstract = "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.",

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author = "Orlagh Feehan and Armstrong, \{David J\} and Magee, \{Pamela J\} and Pourshahidi, \{Kirsty L\} and Strain, \{J J\} and Laura Beggan and Cobice, \{Diego F\} and McSorley, \{Emeir M\}",

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: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

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doi = "10.3390/nu14132680",

language = "English",

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TY - JOUR

T1 - Vitamin D and Bone Health of Older Adults within Care Homes: An Observational Study

AU - Feehan, Orlagh

AU - Armstrong, David J

AU - Magee, Pamela J

AU - Pourshahidi, Kirsty L

AU - Strain, J J

AU - Beggan, Laura

AU - Cobice, Diego F

AU - McSorley, Emeir M

N1 - 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.

PY - 2022/7/1

Y1 - 2022/7/1

N2 - 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.

AB - 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.

KW - vitamin D supplementation

KW - nursing home

KW - osteoporosis

KW - vitamin D deficiency

KW - aged

KW - 80 and over

KW - Bone Density

KW - Calcium

KW - Humans

KW - Vitamin D Deficiency

KW - Collagen Type I

KW - Vitamin D Supplementation

KW - Nursing Home

KW - Vitamins

KW - Osteoporosis

KW - Vitamin D

KW - Aged, 80 and over

KW - Biomarkers

KW - Bone Density/physiology

KW - Vitamin D Deficiency/epidemiology

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U2 - 10.3390/nu14132680

DO - 10.3390/nu14132680

M3 - Article

C2 - 35807859

SN - 2072-6643

VL - 14

SP - 1

EP - 15

JO - Nutrients

JF - Nutrients

IS - 13

M1 - 2680

ER -

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

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Early life vitamin D status: implications for child neurodevelopment

Musculoskeletal health in care homes: the role of vitamin D and nutrition

Cite this

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

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Student theses

Early life vitamin D status: implications for child neurodevelopment

Musculoskeletal health in care homes: the role of vitamin D and nutrition

Cite this