Vit. D studies: Deficiency in elderly men; in peripheral art.disease; in back pain in older women; plus calcium for bone health

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Vitamin D Deficiency is Widespread in Elderly Men

Reference: " [Vitamin D deficiency in elderly men living in urban

areas, at home or in institutions], " Bouuaert C, Vanmeerbeek M, et al,

Presse Med, 2008; 37(2 Pt 1): 191-200. (Address: Département de médecine

générale, Université de Liège, BE-4000 Liège, Belgique. E-mail:

corinne.bouuaert@... ).

Summary: In a study involving 291 elderly men (174 community-dwelling

and 117 institutionalized) aged 65 years or older, severe vitamin D

deficiency (25(OH)D < 12 ng/ml) was found to be quite prevalent, among

community-dwelling (57%) and institutionalized (79%) elderly men. Mild

and moderate vitamin D deficiency (25(OH)D between 12 and 32 ng/ml) was

found among 21% of institutionalized and 42% of community-dwelling men.

Of all the subjects, only 2 were found to have normal levels of vitamin

D (25(OH)D of 32 ng/ml or greater). The authors conclude, " Vitamin D

supplementation should be routinely prescribed in institutions for the

elderly and probably also to any individual over 65 years. "

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Low Serum Vitamin D Levels May Be Associated with a Higher Prevalence

of Peripheral Arterial Disease

Reference: " Serum 25-Hydroxyvitamin D Levels and the Prevalence of

Peripheral Arterial Disease. Results from NHANES 2001 to 2004, " Melamed

ML, Raggi P, et al, Arterioscler Thromb Vasc Biol, 2008 Apr 16; [Epub

ahead of print]. (Address: Departments of Medicine and Epidemiology &

Population Health, Albert Einstein College of Medicine, Bronx, New York,

USA. E-mail: mmelamed@... ).

Summary: In a study involving 4,839 participants of the National Health

and Nutrition Examination Survey (2001-2004), results indicate that low

vitamin D levels may be associated with a higher prevalence of

peripheral arterial disease (PAD: defined as ankle-brachial index <

0.9). The prevalence of PAD was 8.1% in the lowest quartile of serum

25-hydroxyvitamin D [25(OH)D](<17.8 ng/mL), 5.4% in the second quartile,

4.9% in the third quartile, and 3.7% in the highest quartile (>= 29.2

ng/mL). After adjusting for potential confounders, the lowest quartile

of serum 25(OH)D levels showed an 80% increased prevalence of PAD,

compared with the highest quartile. Additionally, every 10 ng/mL

decrease in serum 25(OH)D level was associated with a 35% increase in

prevalence of PAD. Thus, the authors of this study conclude, " Low serum

25(OH)D levels are associated with a higher prevalence of PAD. Several

mechanisms have been invoked in the literature to support a potential

antiatherosclerotic activity of vitamin D. Prospective cohort and

mechanistic studies should be designed to confirm this association. "

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Low Vitamin D Levels May Be Associated with Significant Back Pain in

Older Women

Reference: " Associations Between Vitamin D Status and Pain in Older

Adults: The Invecchiare in Chianti Study, " Hicks GE, Ferrucci L, et al,

J Am Geriatr Soc, 2008 Mar 5; [Epub ahead of print]. (Address:

E. Hicks, PhD, PT, University of Delaware, Department of Physical

Therapy, 303 McKinly Lab, Newark, DE 19716, USA. E-mail: ghicks@... ).

Summary: In a cross-sectional study involving 958 men and women aged 65

years or more, results indicate that in women, moderate to severe back

pain may be associated with vitamin D deficiency (25-hydroxyvitamin D

[25(OH)D] less than 25 nmol/L). Pain in lower extremities and back was

assessed and vitamin D levels were measured in the participants. 58% of

women and 27% of men reported at least moderate pain in some location.

After adjusting for potential confounders, no association was observed

between vitamin D deficiency and lower extremity pain or lower extremity

and back pain. However, in women, vitamin D deficiency was associated

with a 96% increased risk of moderate to severe back pain without lower

extremity pain. Thus, the authors of this study conclude, " Lower

concentrations of 25(OH)D are associated with significant back pain in

older women but not men. Because vitamin D deficiency and chronic pain

are fairly prevalent in older ad ults, these findings suggest it may be

worthwhile to query older adults about their pain and screen older women

with significant back pain for vitamin D deficiency. "

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Addition of Vitamin D to Calcium Benefits Bone Health in Elderly Women

Reference: " Effects of Calcium and Vitamin D Supplementation on Hip

Bone Mineral Density and Calcium-Related Analytes in Elderly Ambulatory

Australian Women: A Five-Year Randomized Controlled Trial, " Zhu K,

Devine A, et al, Journal of Clinical Endocrinology and Metabolism, 2008;

93(3): 743-749. (Address: R. L. Prince, M.D., Department of

Endocrinology and Diabetes, Sir Gairdner Hospital, Nedlands,

Western Australia 6009, Australia. E-mail: rlprince@... ).

Summary: In a randomized, controlled, double-blind trial involving 120

women between the ages of 70 and 80 years, supplementation with vitamin

D2 (1000 IU/d), added to supplementation with calcium (1200 mg/d) was

found to have long-term beneficial effects on bone mineral density, as

compared to supplementation with calcium alone, over a five year period.

After 1 year, hip BMD was preserved, plasma alkaline phosphatase levels

were reduced, and urinary deoxypyridinoline to creatine ratio was

reduced among subjects given calcium plus vitamin D, as well as subjects

given calcium alone. However, after 5 years, these benefits were

maintained only among subjects given calcium plus vitamin D. The

greatest benefits were found among subjects with levels of 25(OH)D below

the median (68 nmol/liter) . Parathyroid hormone (PTH) levels in

subjects whose baseline PTH levels were above the median were also

reduced among subjects taking calcium pl us vitamin D after 3 and 5

years. The authors conclude, " Addition of vitamin D to calcium has

long-term beneficial effects on bone density in elderly women living in

a sunny climate, probably mediated by a long-term reduction in bone

turnover rate. "

--

ne Holden, MS, RD

" Ask the Parkinson Dietitian " http://www.parkinson.org/

" Eat well, stay well with Parkinson's disease "

" Parkinson's disease: Guidelines for Medical Nutrition Therapy "

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