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Zeitschrift für Gerontologie und Geriatrie

, Volume 46, Issue 5, pp 403–409 | Cite as

Vitamin D status and physical function in nursing home residents: a 1-year observational study

  • R. DiekmannEmail author
  • K. Winning
  • J.M. Bauer
  • W. Uter
  • P. Stehle
  • S. Lesser
  • T. Bertsch
  • C.C. Sieber
  • D. Volkert
Beiträge zum Themenschwerpunkt

Abstract

Objective

Low vitamin D blood levels are highly prevalent in elderly people, particularly in nursing home residents (NHR). A relation between vitamin D levels and physical function (PF) is described in several studies in older adults; however, data on NHR are scarce and there is presently no information on the time course of vitamin D levels and PF in this population. The aim of the present study was to describe the 25-hydroxyvitamin D [25(OH)D] status of NHR at baseline (t1) and after 1 year (t2) to examine whether 25(OH)D blood levels are related to PF at t1 and at t2, and whether changes in 25(OH)D levels over 1 year are related to changes in PF.

Methods

All NHR (≥ 65 years) without tube-feeding and severe acute or end-stage disease were asked to participate. At t1 and t2 fasting blood samples were taken for the analysis of 25(OH)D serum levels and PF was estimated by activities of daily living (Barthel ADL) and measured by handgrip strength (HGS) and timed ‘up and go’ test (TUG).

Results

In total, 115 residents, aged 87 (82–93) years (all data in median and 1st–3rd quartile), showed the following values for PF: ADL 50 (20–65) points, HGS 40 (30–50) kPa and TUG 26 (18–31) s. Vitamin D deficiency (< 50 nmol/l) was present in 93.9 % (70.4 % < 25 nmol/l) at t1 and in 71.2 % (57.3 % < 25 nmol/l) at t2. At t1 and at t2 a weak correlation between vitamin D level and PF (Spearman’s correlation coefficient t1: ADL r = 0.367, HGS r = 0.313; t2: ADL: r = 0.247; all p < 0.01) was observed. There was no correlation between changes in vitamin D levels over 1 year and changes in PF.

Conclusions

Almost all NHR included in the study showed vitamin D deficiency. 25(OH)D levels were weakly correlated to PF at baseline and at follow-up, and an increase in vitamin D levels was not associated with positive effects on PF in this study.

Keywords

Nursing home Institutionalized elderly 25-Hydroxyvitamin D Physical functionality Supplementation 

Vitamin-D-Status und körperliche Funktionalität bei Pflegeheimbewohnern: eine 1-Jahres-Beobachtungsstudie

Zusammenfassung

Hintergrund

Senioren und insbesondere Pflegeheimbewohner (PHB) weisen häufig geringe Vitamin-D-Blutspiegel auf. Ein Zusammenhang zwischen Vitamin-D-Aufnahme und körperlicher Funktionalität (KF) wurde bei älteren Menschen beschrieben, allerdings sind Daten von PHB rar, und Informationen zum Zusammenhang von Vitamin-D-Blutspiegel und KF liegen bisher nicht in publizierter Form vor. Ziel der vorliegenden Studie war die Beschreibung des Vitamin-D-Status bei PHB zu Beginn (t1) und nach einem Jahr (t2), die Untersuchung des Zusammenhangs von Vitamin D und KF zu t1 und t2 sowie die Entwicklung der Vitamin-D-Spiegel im Verlauf und ihr Einfluss auf die KF.

Methodik

In die Studie aufgenommen wurden alle PHB (≥ 65 Jahre) ohne schwere akute oder terminale Erkrankung oder Sonderernährung. Es folgte eine Blutentnahme und Analyse der 25(OH)D-Serumspiegel sowie die Ermittlung der KF mittels Barthel-Index zu Aktivitäten des täglichen Lebens (ADL), Handkraft (HK) und Zeit zum Aufstehen und Gehen, d. h. Timed-Up-and-Go (TUG)-Test, zu t1 und t2.

Ergebnisse

115 PHB im Alter von 87 (82–93) Jahren (jeweils Median und 1.–3. Quartile) wiesen folgende KF auf: ADL: 50 (20–65) Punkte, HK: 40 (30–50) kPa und TUG: 26 (18–31) s. Die Prävalenz des Vitamin-D-Mangels (< 50 nmol/l) betrug zu t1: 93,9 % (70,4 % < 25 nmol/l), zu t2: 71,2 % (57,3 % < 25 nmol/l). Zwischen Vitamin D und KF bestand eine schwache Korrelation zum Zeitpunkt t1 und t2 (Korrelationskoeffizient nach Spearman t1: ADL: r = 0,367; HK: r = 0,313; und t2: ADL: r = 0,247; alle p < 0,01). Es zeigte sich kein Zusammenhang zwischen den Veränderungen im Vitamin-D-Spiegel und Veränderungen der KF.

Schlussfolgerung

Fast jeder PHB wies einen Vitamin-D-Mangel auf. Der Zusammenhang zwischen Blutspiegel und KF war in dieser Gruppe sowohl zu Beginn als auch nach einem Jahr schwach. Eine Veränderung der Vitamin-D-Spiegel hatte in der vorliegenden Untersuchung keine Veränderung der KF zur Folge.

Schlüsselwörter

Pflegeheim Altenheim 25-Hydroxyvitamin D Körperliche Funktionalität Supplementierung 

Notes

Conflicts of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • R. Diekmann
    • 1
    Email author
  • K. Winning
    • 1
  • J.M. Bauer
    • 1
    • 2
  • W. Uter
    • 3
  • P. Stehle
    • 4
  • S. Lesser
    • 4
  • T. Bertsch
    • 5
  • C.C. Sieber
    • 1
  • D. Volkert
    • 1
  1. 1.Institute for Biomedicine of Aging (IBA)Friedrich-Alexander-Universität Erlangen-NürnbergNurembergGermany
  2. 2.Geriatric Center OldenburgEuropean Medical School (EMS) Groningen-OldenburgOldenburgGermany
  3. 3.Department of Medical Informatics, Biometry and Epidemiology (IMBE)Friedrich-Alexander-Universität Erlangen-NürnbergNurembergGermany
  4. 4.Department of Nutrition and Food Sciences (IEL) - Nutritional PhysiologyRheinische Friedrich-Wilhelms-Universität BonnBonnGermany
  5. 5.Institute for Clinical Chemistry, Laboratory Medicine and Transfusion MedicineNuremberg ClinicNurembergGermany

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