Seniors need more Vitamin D (Geriatric Ward in this case) - Jan 2024

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Vitamin D Status among Patients Admitted to a Geriatric Ward-Are Recommendations for Preventing Its Deficiency Effective Enough?

Nutrients 2024 Jan 6;16(2):193. doi: 10.3390/nu16020193.
Maksymilian Adam Lech 1, Marcin Warpechowski 1, Aleksandra Wojszel 1, Justyna Rentflejsz 2 3 4, Marta Świętek 4, Zyta Beata Wojszel 3 4

Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it is important to note that this research did not include the elderly living in care institutions. Therefore, our study concentrates on evaluating VD status in older patients admitted to a geriatrics ward to indirectly assess their adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviors (i.e., taking vitamin D supplements) and whether the recommended, optimal 25(OH)D concentration values are achieved). This approach offers a comprehensive understanding of VD status in a previously understudied population. We aimed to evaluate VD status in patients aged 70 and above within the geriatrics ward, exploring its association with age, sex, BMI, and the use of VD supplements. The study involved the measurement of serum VD concentration in 240 individuals. Of these participants, 177 (73.8%) were women, and 193 (80.4%) were over 75 years old.
The median 25(OH)D concentration was found to be 22.95 (IQR, 13.7-33.0) ng/mL.
Notably, profound deficiency (<10 ng/mL) was noted in 15% of the participants, while 67.5% exhibited VD inadequacy (<30 ng/mL).
It is worth mentioning that only 18.3% of individuals took VD supplements preadmission. Insufficiency was more prevalent in nonsupplemented individuals (70.9% vs. 52.3%, p = 0.02) and those with a BMI ≥30 kg/m2 (76.2% vs. 59.2%, p = 0.007).
The logistic regression model demonstrated that obese patients had over two times higher odds of VD inadequacy (OR = 2.21, p = 0.0074), as did nonsupplemented individuals (OR = 2.23, p = 0.0187). The high prevalence of VD deficiency and inadequacy in geriatric ward admissions emphasizes the urgent need for targeted interventions and enhanced education for older adults, caregivers, and physicians to improve adherence to preventive supplementation practices.
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VitaminDWiki – 13 reasons why many seniors need more vitamin D (both dose and level) - July 2023

1. Senior skin produces 4X less Vitamin D for the same sun intensity
2. Seniors have fewer vitamin D receptor genes as they age
   Receptors are needed to get Vitamin D in blood actually into the cells
3. Many other Vitamin D genes decrease with age
4. Since many gene activations are not detected by a blood test,
   more Vitamin D is often needed, especially by seniors
5. Seniors are indoors more than when they were younger
   not as agile, weaker muscles; frail, no longer enjoy hot temperatures
6. Seniors wear more clothing outdoors than when younger
   Seniors also are told to fear skin cancer & wrinkles
7. Seniors often take various drugs which end up reducing vitamin D
   Some reductions are not detected by a vitamin D test of the blood
   statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc
8. Seniors often have one or more diseases that consume vitamin D
   osteoporosis, diabetes, Multiple Sclerosis, Cancer, ...
9. Seniors generally put on weight as they age - and a heavier body requires more vitamin D
10. Seniors often (40%) have fatty livers – which do not process vitamin D as well
11. Reduced stomach acid means less Magnesium is available to get vitamin D into the cells
12. Vitamin D is not as bioavailable in senior intestines
13. Seniors with poorly functioning kidneys do not process vitamin D as well
14. Glutathione (which increases Vitamin D getting to cells) decreases with age
       Seniors category has 430 items

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VitaminDWiki – Elderly often trapped in vitamin D vicious circles