The problems of vitamin d insufficiency in older people - PubMed (original) (raw)

The problems of vitamin d insufficiency in older people

Barbara J Boucher. Aging Dis. 2012 Aug.

Abstract

This report reviews evidence on disorders related to inadequate vitamin D repletion in older people. Vitamin D is as essential for bone health in adults as in children, preventing osteomalacia and muscle weakness and protecting against falls and low-impact fractures. Vitamin D is provided by skin synthesis by UVB-irradiation from summer sunshine and to a small extent by absorption from food. However, these processes become less efficient with age. Loss of mobility or residential care restricts solar exposure. Reduced appetite and financial problems often add to these problems. Thus, hypovitaminosis D is common world-wide, but is more common and more severe in older people. Non-classical effects of vitamin D, depending on serum circulating 25-hydroxyvitamin D concentrations, are present in most non-bony tissues; disorders associated with hypovitaminosis D include increased risks of sepsis [bacterial, mycobacterial and viral], cardiovascular and metabolic disorders [e.g. hyperlipidemia, type 2 diabetes mellitus, acute vascular events, dementia, stroke and heart failure]. Many cancer risks are associated with vitamin D inadequacy, though causality is accepted only for colo-rectal cancer. Maintenance of repletion in healthy older people requires intakes of ≥800IU/day [20μg], as advised by the Institute of Medicine [IOM], but achieving such intakes usually requires supplementation. Excessive intakes are dangerous, especially in undiagnosed primary hyperparathyroidism or sarcoidosis, but the IOM finds doses <4000 IU/day are safe. Many experts suggest that ≥1000-2000 IU [25-50μg] of vitamin D daily is necessary for older people, especially when independence is lost, or hypovitaminosis D could add to the clinical problem[s]. Much higher doses than these are needed for treatment of established deficiency or insufficiency.

Keywords: aging; deficiency; elderly; pathology; supplementation; vitamin D.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Holick MF. Photobiology of vitamin D. Chapter 2:113–22. In: Feldman D, Pike JW, Adams JS, editors. Vitamin D. Vol. 1. Academic Press; Elsevier: 2011.
    1. Calvo MS, Whiting SJ, Barton CN. Vitamin D intake: a global perspective of current status. J Nutr. 2005;135:310–6. - PubMed
    1. Prentice A. Vitamin D deficiency: a global perspective. Nutr Rev. 2008;66(10 Suppl 2):S153–64. - PubMed
    1. Editorial Nutrition of the elderly. Lancet. 1968;5619:629–30. - PMC - PubMed
    1. Corless D, Gupta SP, Sattar DA, Switala S, Boucher BJ. Vitamin D status of residents of an old people’s home and long-stay patients. Gerontology. 1979;25:350–5. - PubMed

LinkOut - more resources