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. 2017 Oct 10;17(1):229.
doi: 10.1186/s12877-017-0622-1.

Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents

Rebeka Arnljots  1   2   3 , Jörgen Thorn  4 , Marie Elm  5 , Michael Moore  6 , Pär-Daniel Sundvall  7   4   8
Affiliations

Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents

Rebeka Arnljots et al. BMC Geriatr. .

Abstract

Background: Residents of nursing homes may have low 25-hydroxyvitamin D (25OHD) concentrations. Associations between vitamin D and cognitive performance, dementia and susceptibility to infections are not clearly established. The aim of this study was to investigate the prevalence of vitamin D deficiency and to identify associated factors among residents of nursing homes for elderly.

Methods: In this cross-sectional study blood samples for analysis of 25OHD were collected from all participating residents of Swedish nursing homes for the elderly from January to March 2012.

Exclusion criteria: dementia too severe to collect a blood test, terminally ill or refusing participation.

Outcome measures: Serum 25OHD concentrations. Logistic regression to evaluate factors associated with vitamin D deficiency (25OHD < 25 nmol/L).

Results: Blood samples were obtained from 545 of 901 residents of 22 nursing homes. Mean age 86 years (SD 6.9), 68% were women. Prevalence of vitamin D supplementation 17%, dementia 55%, lack of appetite ≥3 months 45% and any antibiotic treatment during the last 6 months 30%. Serum 25OHD concentrations: mean 34 nmol/L (SD 21, median 27, range 4-125), 82% (448/545) had 25OHD < 50 nmol/L and 41% (224/545) had 25OHD < 25 nmol/L. Adjusted OR (95% CI; p-value) for possible predictors of vitamin D deficiency (25OHD < 25 nmol/L): vitamin D supplementation 0.075 (0.031-0.18; p < 0.001), lack of appetite ≥3 months 0.75 (0.50-1.1; p = 0.15), hours outdoors/week 0.99 (0.96-1.0; p = 0.62), Fitzpatrick skin phototype (4-6) 0.69 (0.44-1.1; p = 0.12); dementia 2.3 (1.5-3.4; p < 0.001) and antibiotics last 6 months 1.6 (1.1-2.6; p < 0.029), adjusted for age and gender.

Conclusions: Vitamin D deficiency was common among nursing home residents and strongly associated with dementia. Regardless of causality or not, it is important to be alert for vitamin D deficiency in nursing homes residents with dementia. As expected vitamin D supplementation was associated with less vitamin D deficiency, however lack of appetite, staying outdoors and skin phototype were not significant predictors. Antibiotic treatments during the last 6 months were associated with vitamin D deficiency, potentially supporting the hypothesis that vitamin D deficiency is associated with infections.

Keywords: Antibiotics; Dementia; Frail elderly; Homes for the aged; Infectious disease; Nursing homes; Vitamin D.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Regional ethical review board of Gothenburg University (D-nr 578–11). All residents were informed of the study both verbally and in writing. From decision-capable individuals choosing to participate in the study, informed approval was collected. However, a considerable number of participants consisted of residents with dementia of varying degrees. If the resident was incapable of understanding the given information and thereby possessing a reduced decision capability, these residents only participated so long as they both: Did not oppose participation in the study and that the appointed representatives or relatives did not oppose their participation after being provided with information about the study. The Regional ethical review board of Gothenburg University approved this procedure.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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Fig. 1
Participant flow chart
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