Skip to main content

Advertisement

SpringerLink
Log in

Physical inactivity and vitamin D deficiency in hospitalized elderlies

  • Original Article
  • Published:
Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Serum levels of 25(OH)D, which is known to correlate with systemic nutritional status, is used as an indicator of vitamin D sufficiency in the body. We studied the 25(OH)D status and its background factors including activity of daily living (ADL) in the elderlies hospitalized at the regional core hospital. We also examined whether or not vitamin D deficiency affects ADL among them. This study included newly hospitalized patients aged 65 years or over at Ohchi hospital April to August in 2015. At the time of admission, serum 25(OH)D concentration was measured, and ADL, instrumental ADL (IADL), cognitive function, blood test, nursing care certification were investigated as background factors. Among 209 patients, 25(OH)D was sufficient (> 30 ng/mL) only 14 cases (7%), insufficient (20–30 ng/mL) in 43 cases (20%), and deficient (< 20 ng/mL) in 152 cases (73%). Multivariate analysis showed that low ADL (OR 0.99, 95% CI 0.97–0.99) and low IADL (OR 0.88, 95% CI 0.78–0.99) were independent predictors of 25(OH)D deficiency in two models incorporating ADL and IADL, respectively. Furthermore, low 25(OH)D level was significantly associated with low ADL (OR 0.95, 95% CI 0.91–0.99) and low IADL (OR 0.93, 95% CI 0.88–0.97) scores, suggesting that vitamin D deficiency may affect physical activities. Most hospitalized elderly patients in Japan were deficient for vitamin D. In addition, physical inactivity is strongly associated with vitamin D deficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281

    Article  CAS  PubMed  Google Scholar 

  2. Gallagher JC, Sai AJ (2010) Vitamin D insufficiency, deficiency, and bone health. J Clin Endocrinol Metab 95:2630–2633

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Ceglia L (2009) Vitamin D and its role in skeletal muscle. Curr Opin Clin Nutr Metab Care 12:628–633

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Aranow C (2011) Vitamin D and the immune system. J Investig Med 59:881–886

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Lips P (2007) Relative value of 25(OH)D and 1,25(OH)2D measurements. J Bone Miner Res 22:1668–1671

    Article  CAS  PubMed  Google Scholar 

  6. Okazaki R, Ozono K, Fukumoto S, Inoue D, Yamauchi M, Minagawa M, Michigami T, Takeuchi Y, Matsumoto T, Sugimoto T (2017) Assessment criteria for vitamin D deficiency/insufficiency in Japan: proposal by an expert panel supported by the Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, the Japanese Society for Bone and Mineral Research and the Japan Endocrine Society [Opinion]. J Bone Miner Metab 35:1–5

    Article  CAS  PubMed  Google Scholar 

  7. Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, Nickelsen T (2001) A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 86:1212–1221

    Article  CAS  PubMed  Google Scholar 

  8. Looker AC, Mussolino ME (2008) Serum 25-hydroxyvitamin D and hip fracture risk in older US white adults. J Bone Miner Res 23:143–150

    Article  CAS  PubMed  Google Scholar 

  9. Ensrud KE, Taylor BC, Paudel ML, Cauley JA, Cawthon PM, Cummings SR, Fink HA, Barrett-Connor E, Zmuda JM, Shikany JM, Orwoll ES, Osteoporotic Fractures in Men Study Group (2009) Serum 25-hydroxyvitamin D levels and rate of hip bone loss in older men. J Clin Endocrinol Metab 94:2773–2780

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Houston DK, Tooze JA, Davis CC, Chaves PH, Hirsch CH, Robbins JA, Arnold AM, Newman AB, Kritchevsky SB (2011) Serum 25-hydroxyvitamin D and physical function in older adults: the Cardiovascular Health Study All Stars. J Am Geriatr Soc 59:1793–1801

    Article  PubMed  PubMed Central  Google Scholar 

  11. Buell JS, Dawson-Hughes B, Scott TM, Weiner DE, Dallal GE, Qui WQ, Bergethon P, Rosenberg IH, Folstein MF, Patz S, Bhadelia RA, Tucker KL (2010) 25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services. Neurology 74:18–26

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Stamp TC, Round JM (1974) Seasonal changes in human plasma levels of 25-hydroxyvitamin D. Nature 247:563–565

    Article  CAS  PubMed  Google Scholar 

  13. Scharla SH, Scheidt-Nave C, Leidig G, Woitge H, Wuster C, Seibel MJ, Ziegler R (1996) Lower serum 25-hydroxyvitamin D is associated with increased bone resorption markers and lower bone density at the proximal femur in normal females: a population-based study. Exp Clin Endocrinol Diabetes 104:289–292

    Article  CAS  PubMed  Google Scholar 

  14. Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67:373–378

    Article  CAS  PubMed  Google Scholar 

  15. Delle Monache S, Di Fulvio P, Iannetti E, Valerii L, Capone L, Nespoli MG, Bologna M, Angelucci A (2019) Body mass index represents a good predictor of vitamin D status in women independently from age. Clin Nutr 38:829–834. https://doi.org/10.1016/j.clnu.2018.02.024

    Article  PubMed  Google Scholar 

  16. Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel Index. Md State Med J 14:61–65

    CAS  PubMed  Google Scholar 

  17. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186

    Article  CAS  PubMed  Google Scholar 

  18. Hopman-Rock M, Tak EC, Staats PG (2001) Development and validation of the observation list for early signs of dementia (OLD). Int J Geriatr Psychiatry 16:406–414

    Article  CAS  PubMed  Google Scholar 

  19. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28

    Article  CAS  PubMed  Google Scholar 

  20. Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP (2007) A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 55:234–239

    Article  PubMed  Google Scholar 

  21. Giovannucci E, Liu Y, Hollis BW, Rimm EB (2008) 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 168:1174–1180

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Welsh P, Doolin O, McConnachie A, Boulton E, McNeil G, Macdonald H, Hardcastle A, Hart C, Upton M, Watt G, Sattar N (2012) Circulating 25OHD, dietary vitamin D, PTH, and calcium associations with incident cardiovascular disease and mortality: the MIDSPAN Family Study. J Clin Endocrinol Metab 97:4578–4587

    Article  CAS  PubMed  Google Scholar 

  23. Skalska A, Galas A, Grodzicki T (2012) 25-hydroxyvitamin D and physical and cognitive performance in older people with chronic conditions. Pol Arch Med Wewn 122:162–169

    CAS  PubMed  Google Scholar 

  24. Arnljots R, Thorn J, Elm M, Moore M, Sundvall PD (2017) Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents. BMC Geriatr 17:229

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Gorham ED, Garland CF, Garland FC, Grant WB, Mohr SB, Lipkin M, Newmark HL, Giovannucci E, Wei M, Holick MF (2005) Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol 97:179–194

    Article  CAS  PubMed  Google Scholar 

  26. Ahonen MH, Tenkanen L, Teppo L, Hakama M, Tuohimaa P (2000) Prostate cancer risk and prediagnostic serum 25-hydroxyvitamin D levels (Finland). Cancer Causes Control 11:847–852

    Article  CAS  PubMed  Google Scholar 

  27. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A (2006) Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 296:2832–2838

    Article  CAS  PubMed  Google Scholar 

  28. Garland CF, Kim JJ, Mohr SB, Gorham ED, Grant WB, Giovannucci EL, Baggerly L, Hofflich H, Ramsdell JW, Zeng K, Heaney RP (2014) Meta-analysis of all-cause mortality according to serum 25-hydroxyvitamin D. Am J Public Health 104:e43–e50

    Article  PubMed  PubMed Central  Google Scholar 

  29. Plotnikoff GA, Quigley JM (2003) Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc 78:1463–1470

    Article  PubMed  Google Scholar 

  30. Nanri A, Foo LH, Nakamura K, Hori A, Poudel-Tandukar K, Matsushita Y, Mizoue T (2011) Serum 25-hydroxyvitamin d concentrations and season-specific correlates in Japanese adults. J Epidemiol 21:346–353

    Article  PubMed  PubMed Central  Google Scholar 

  31. Nakamura K, Kitamura K, Takachi R, Saito T, Kobayashi R, Oshiki R, Watanabe Y, Tsugane S, Sasaki A, Yamazaki O (2015) Impact of demographic, environmental, and lifestyle factors on vitamin D sufficiency in 9084 Japanese adults. Bone 74:10–17

    Article  CAS  PubMed  Google Scholar 

  32. Tanaka S, Kuroda T, Yamazaki Y, Shiraki Y, Yoshimura N, Shiraki M (2014) Serum 25-hydroxyvitamin D below 25 ng/mL is a risk factor for long bone fracture comparable to bone mineral density in Japanese postmenopausal women. J Bone Miner Metab 32:514–523

    Article  CAS  PubMed  Google Scholar 

  33. Okazaki R, Sugimoto T, Kaji H, Fujii Y, Shiraki M, Inoue D, Endo I, Okano T, Hirota T, Kurahashi I, Matsumoto T (2011) Vitamin D insufficiency defined by serum 25-hydroxyvitamin D and parathyroid hormone before and after oral vitamin D(3) load in Japanese subjects. J Bone Miner Metab 29:103–110

    Article  CAS  PubMed  Google Scholar 

  34. Tamaki J, Iki M, Sato Y, Kajita E, Nishino H, Akiba T, Matsumoto T, Kagamimori S, JPOS Study Group (2017) Total 25-hydroxyvitamin D levels predict fracture risk: results from the 15-year follow-up of the Japanese Population-based Osteoporosis (JPOS) Cohort Study. Osteoporos Int 28:1903–1913

    Article  CAS  PubMed  Google Scholar 

  35. Ikeda S, Nomura S (2015) Is vitamin D intake sufficient in Japanese adults? Its findings from the National Health and Nutrition Survey (NHNS) in Japan. Vitam Soc Jpn (in Japanese) 89:453–458

    CAS  Google Scholar 

  36. Scragg R, Camargo CA Jr (2008) Frequency of leisure-time physical activity and serum 25-hydroxyvitamin D levels in the US population: results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 168:577–586 (discussion 87–91)

    Article  PubMed  PubMed Central  Google Scholar 

  37. Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ (1992) Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 327:1637–1642

    Article  CAS  PubMed  Google Scholar 

  38. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337:670–676

    Article  CAS  PubMed  Google Scholar 

  39. Kennel KA, Drake MT, Hurley DL (2010) Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc 85:752–757 (quiz 7–8)

    Article  PubMed  PubMed Central  Google Scholar 

  40. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Authors appreciate all the staff of Ohchi Hospital for their skillful assistant. Authors also appreciate the Academic Knowledge Network (AKN) project conducted by Shimane Prefecture, Ohchi Hospital, and Center for community-based healthcare research and education (CoHRE) in Shimane University.

Funding

This work is partly supported by subsidy of Shimane Prefecture (to ST) and by JSPS KAKENHI Grant number JP16K13029 (to SY). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Emergency Care, Shimane Prefectural Central Hospital, Izumo, Japan

    Shota Tanabe

  2. Department of General Medicine, Ohchi Hospital, Ochi, Japan

    Shota Tanabe

  3. Department of Laboratory Medicine, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan

    Shozo Yano & Atsushi Nagai

  4. Nutrition Support Center, Shimane University Hospital, Izumo, Japan

    Shozo Yano

  5. Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Matsue, Japan

    Shozo Yano

  6. Central of Clinical Laboratory, Shimane University Hospital, Izumo, Japan

    Seiji Mishima & Atsushi Nagai

Authors
  1. Shota Tanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shozo Yano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seiji Mishima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atsushi Nagai
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceived and designed the experiments: ST SY, collected the data: ST, analyzed the data: ST, supervised: SM AN, wrote the manuscript: ST, and edited the manuscript: SY.

Corresponding author

Correspondence to Shozo Yano.

Ethics declarations

Conflict of interest

All authors have no conflicts of interest.

Additional information

Publisher's Note

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

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tanabe, S., Yano, S., Mishima, S. et al. Physical inactivity and vitamin D deficiency in hospitalized elderlies. J Bone Miner Metab 37, 928–934 (2019). https://doi.org/10.1007/s00774-019-00996-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00774-019-00996-z

Keywords

Search

Navigation