Urgent action needed to improve vitamin D status among older people in England!

Abstract

Background: the importance of vitamin D for bone health is well known, but emerging evidence also suggests that adequate vitamin D status may also be protective against non-communicable diseases. In the UK, government initiatives highlighting the importance of adequate vitamin D among older people have been in place since 1998.

Objectives: the aim of this analysis is to assess vitamin D status in people aged > or =65, living in private households in England, 2005 and make comparisons with the Health Survey for England (HSE) 2000 and the National Diet and Nutrition Survey (NDNS), 1994. We also examine associations of hypovitaminosis D [serum 25(OH)D <50 nmol/l] with demographic, geographic, lifestyle and health risk factors.

Design and setting: a nationally representative sample of older people living in England in 2005.

Participants: 2,070 adults aged > or =65, living in private households taking part in the HSE 2005.

Results: in the HSE 2005, mean serum 25(OH)D levels were 53 and 49 nmol/l in men and women, respectively, these levels are significantly lower than currently recommended at > or =75 nmol/l. Prevalence of vitamin D deficiency [25(OH)D <25 nmol/l] in people aged > or =65 in 2005 was 13% in women and 8% in men. Nearly two thirds (57%) of women and half of men (49%) had serum 25(OH)D <50 nmol/l. Only 16% of men and 13% of women aged > or =65 years had serum 25(OH)D levels > or =75 nmol/l. There is no improvement in vitamin D status in 2005 compared to 2000 and a significant decline in vitamin D status among men in 2005 in comparison to the 1994/1995 NDNS results. The odds of hypovitaminosis D increased by age group from those aged 75-79 to aged > or =85. Season of taking a blood sample, obesity, dark skin pigmentation, not taking vitamin supplements, cigarette smoking, poor general health and longstanding illness were all significant predictors (P < 0.05) of serum 25(OH)D status in adjusted regression models.

Conclusions: poor vitamin D status of older people continues to be a public health problem in England. Hypovitaminosis D is associated with many risk factors and poor health outcomes. There is now an urgent need for a uniform policy on assessment and dietary supplementation of vitamin D in older people to prevent poor vitamin D status and its negative consequences.