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Vitamin D associated with physical function, mortality in older hospitalized patients
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Older adults admitted to the hospital for acute illness with a low vitamin D level are more likely to have a longer length of hospital stay, higher rates of falling and higher mortality rate vs. inpatients with a higher vitamin D level, according to findings presented at the Society for Endocrinology BES annual meeting.
“We have observed associations between vitamin D status and markers of physical function in patients admitted under the acute internal medicine team.” Zaki Hassan-Smith, MBBS, MRCP, PhD, consultant endocrinologist and honorary senior research fellow at the University of Birmingham, U.K., and a visiting professor in the faculty of health and life sciences at Coventry University, told Endocrine Today. “These results do not infer causality, and it may be that the vitamin D function is simply a marker of baseline reductions in a patient’s physical function.”
Hassan-Smith and colleagues analyzed data from 1,332 patients older than 65 years admitted to acute medicine between January 2017 and January 2018, identified by health informatics (739 women). Researchers assessed data on physical function and frailty markers in addition to clinical diagnosis, management and outcomes, and conducted a substudy with 766 patients in which vitamin D status was assessed.
Within the cohort, median serum 25-hydroxyvitamin D level was 31 nmol/L.
Researchers found that patients in the lowest quartile for vitamin D tended to have a longer length of stay vs. those in the highest quartile (median, 34 days vs. 10 days; P < .05), lower abbreviated mental test scores (mean, 5/10 vs. 8/10; P < .05), higher Waterlow ulcer-risk scores (mean, 19 vs. 13) and a trend toward higher fall scores (mean, 2 vs. 1), as well as lower Manchester mobility scores (mean, 5 vs. 6). Additionally, 32% of patients died in the lowest vitamin D quartile vs. 14% in the highest quartile, according to researchers.
Hassan-Smith said the study is retrospective, and prospective supplementation studies in this patient group are required to establish causality. He added that the findings will inform development of a prospective study on the impact of vitamin D status on outcomes in acute illness relating to clinical course and rehabilitation.
“We would like to see large-scale vitamin D supplementation studies in acutely unwell patients to investigate these associations further,” Hassan-Smith said. “In addition, we would be interested in prospective interventional studies in hospital inpatients so that patients can be phenotyped in-depth, with more detailed measures of physical function, frailty and sarcopenia, in addition to metabolomics and inflammatory profiles.” – by Regina Schaffer
Reference:
Alhamamy N, et al. P042. Presented at: Society for Endocrinology BES Annual Meeting; Nov. 19-21, 2018; Glasgow, U.K.
Disclosure: Hassan-Smith reports no relevant financial disclosures.