L15 Vitamin D Deficiency in Institutionalised HD Patients
J Neurol Neurosurg Psychiatry 2014;85:A87-A88 doi:10.1136/jnnp-2014-309032.252
M Loffredo, A Bruin
Huntington Expertisecentre Altlant, Beekbergen, Netherlands
Background Elderly dementia patients are prescribed cholecalciferol (vitamin D) when institutionalized in one of our wards. We follow guidelines from the Dutch Health Council, which are evidence-based. No large-scale research, or guidelines are available on vitamin D deficiency and suppletion in institutionalized patient with HD, Korsakov’s syndrome or Acquired Brain Injury. Chel et alfound high prevalence of vitamin D deficiency and insufficiency among 28 patients in a Dutch Skilled Nursing Facility.
Method In 21 institutionalized HD patients we did blood tests to determine the level of vitamin D (serum 25(OH)D level). In these patients, blood samples had to be drawn for other indications, and the vit D level was assessed at the same time.
Aim Assess the prevalence and level of vitamin D deficiency in our institutionalized HD patients.
Results We found deficiency in all patients included. Mean was 25 nmol/l. Range was 3 – 51 nmol/l (rev. 50-150 nmol/l). Some of these patients are on a high kcal diet, adding drinks/meal replacements with added vitamins to their daily intake.
Conclusions Vitamin D deficiency is common in advanced HD.
Recommendations We recommend lab tests on admission, and prescribe monthly vitamin D to all HD patients with deficiency. In severe deficiency a weekly dose is given for three months. Contra indications (sarcoidosis, hyperkalemia, hyperparathyroidism) should be taken into account by prescribers. Exposure to the sun on a daily basis for at least 30 minutes is not always realistic, but advisable.
References
Chel VG, Ooms ME, van der Bent J, Veldkamp F, et al.
High prevalence of vitamin D deficiency and insufficiency in patients with manifest Huntington disease: An explorative study.
Dermatoendocrinol 2013;5(3):348-51 89% had < 20 ng of vitamin D
- RLS, Tremor, Huntington’s and other hyperkinetic disorders associated with low Vitamin D – review Aug 2020
- Milk increases risk of Parkinson’s and doubles the risk of Huntington’s -July 2019
Overview Alzheimer's-Cognition and Vitamin D has the following summary on VitaminDWiki
- FACT: Cognitive decline is 19X more likely if low vitamin D
- FACT: Dementia is associated with low vitamin D levels.
- FACT: Alzheimer’s Dementia 2.3X more likely in elderly if low vitamin D – Dec 2022
- FACT: Dementia is associated with low vitamin D - many studies
- FACT: Alzheimer's Disease is 4X less likely if high vitamin D
- FACT: Every single risk factor listed for Alzheimer's Disease is also a risk factor for low vitamin D levels
- FACT: Elderly cognition gets worse as the elderly vitamin D levels get even lower (while in senior homes)
- OBSERVATION: Reports of increased vitamin D levels result in improved cognition
- OBSERVATION: Alzheimer’s patients 3X more likely to have a malfunctioning vitamin D receptor gene – 2012
- OBSERVATION: Alzheimer's Disease has been seen to halt when vitamin D was added.
- OBSERVATION: Alzheimer’s is associated with all 7 of the genes which restrict vitamin D
- OBSERVATION: 39 vitamin D and Alz. or Cognition intervention trials as of Sept 2018
- OBSERVATION: 2 Meta-analysis in 2012 agreed that Alzheimer's Disease. associated with low vitamin D
- OBSERVATION: 50X increase in Alzheimer's while decrease in vitamin D
- OBSERVATION: Vitamin D reduces Alzheimer’s disease in 11 ways
- OBSERVATION: Alzheimer’s cognition improved by 4,000 IU of vitamin D
- OBSERVATION: Plaque removed in mice by equiv. of 14,000 IU daily
- OBSERVATION: DDT (which decreases Vit D) increases risk of Alzheimer's by up to 3.8X
- OBSERVATION: 2% of people have 2 copies of the poor gene reference: Alz Org
- OBSERVATION: Genes do not change rapidly enough to account for the huge increase in incidence
- OBSERVATION: End of Alzheimer's videos, transcripts and many studies protocol has been very successful
- It adjusts Vitamin D, B-12, Iron, Omega-3, food, etc, and can now be done at home. $75/month.
- FACT: Vitamin D is extremely low cost and has very very few side effects
- CONCLUSION: Everyone concerned about cognitive decline or Alzheimer's Disease should take vitamin D
- PREDICTION MET: By 2024 Omega-3 and high dose Vitamin D will be found to reverse Alzheimer's in humans
There are 13+ Alzheimer’s meta-analyses in VitaminDWiki
There are 97+ Alzheimer’s studies in VitaminDWiki
Dementia is associated with low vitamin D - many studies 50+ studies
16+ studies in both categories Cognitive and Omega-3
See also web