The effectiveness of a preventive health program and vitamin D status in improving health-related quality of life of older Canadians

Abstract

Purpose: To assess the effectiveness of a preventive health program and vitamin D status in improving the health-related quality of life (HRQOL) of older residents of Canada.

Design: We analyzed baseline and follow-up data of 2119 volunteers of a community program that promotes healthy lifestyles and encourages vitamin D supplementation. We examined the program effect on each of the five dimensions of the EQ-5D-5L, HRQOL score, and quality-adjusted life years (QALYs) using multivariable regression methods. We further examined the specific contribution of vitamin D status as quantified by serum 25-hydroxyvitamin D (25(OH)D).

Results: Problems with mobility, usual activities, pain/discomfort, and depression/anxiety were reported less during follow-up compared to baseline. On average, participants' HRQOL had improved by 0.018 units at 6 months and 0.025 units at 1 year of follow-up. Improvements in vitamin D status were independently associated with improvements in HRQOL and in QALYs. As per 25 nmol/L increase in 25(OH)D, there was a 0.002 increase in HRQOL and a 0.001 increase in QALYs.

Conclusions: This study documents the benefits of a real-world preventive health program to HRQOL. It is the first to reveal that improvements in vitamin D status parallel improvements in HRQOL among healthy community dwellers. The study further suggests that the preventive health program and supplementation with vitamin D are cost-effective interventions.

Keywords: Disease prevention; Health-related quality of life; Intervention; Nutrition; Public health; Vitamin D.

Fig. 1

Temporal changes in HRQOL by baseline HRQOL tertile. Note: Bubbles represent the mean HRQOL level at baseline, at 6 month, and at 1 year of follow-up. The size of the bubbles is proportional to the number of assessments at each reporting time