Prevalence of Vitamin D Deficiency and Association with Functional Status in Newly Admitted Male Veteran Nursing Home Residents
Journal of the American Geriatrics Society, Vol. 61 Issue 9, DOI: 10.1111/jgs.12495
Gotaro Kojima MD1,2,*,
Anna Tamai MD1,2,
Kamal Masaki MD2,
Gregory Gatchell DO1,2,
James Epure MD1,2,
Craig China MD1,2,
G. Webster Ross MD2,3,
Helen Petrovitch MD2,3,
Marianne Tanabe MD1,2
Objectives: To provide the first report on prevalence of vitamin D deficiency in newly admitted nursing home (NH) residents and associations with functional disabilities and chronic diseases.
Design: Retrospective chart review.
Setting: Nursing home (NH).
Participants: Male veterans newly admitted to a NH for rehabilitation, skilled-nursing care, intermediate care, or respite care between January 2011 and June 2012.
Measurements: Total serum 25-hydroxyvitamin D (25(OH)D) levels were measured on admission. Vitamin D supplement users and those without 25(OH)D measurement within 7 days of admission were excluded, leaving an analytical sample of 104 residents. Vitamin D deficiency was defined as 25(OH)D less than 20 ng/mL.
Data were collected on age, ethnicity, season, body mass index (BMI), functional disability in activities of daily living (ADLs) (mobility, bathing, dressing, toileting, continence, and feeding), and prevalent chronic diseases.
Results: Prevalence of vitamin D deficiency was 49.0%. In multivariate logistic regression models adjusted for age, ethnicity, and BMI, vitamin D deficiency was significantly associated with number of ADL disabilities (odds ratio (OR) = 1.4 for each 1-point increase in ADL disability score, P = .03) and prevalent diabetes mellitus (OR = 3.0, P = .03).
In regression models using each ADL disability as a separate variable, only disability in feeding (OR = 4.7, P = .05) and diabetes mellitus (OR = 2.9, P = .04) remained significant.
Conclusion: Almost half the individuals entering the NH and not taking vitamin D supplements had vitamin D deficiency. Greater number of ADL disabilities, disability in feeding, and prevalent diabetes mellitus were independently associated with vitamin D deficiency.
ADL: 0 to 6 scale
6 = full function,
4 = moderate impairment,
2 or less indicates severe functional impairment.