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Associations of 25-Hydroxyvitamin D Status and Supplementation with Adverse Outcomes in Geriatric Rehabilitation Inpatients: RESORT

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The journal of nutrition, health & aging

Abstract

Objectives

Geriatric rehabilitation inpatients are at a higher risk of 25-hydroxyvitamin D (25(OH)D) deficiency due to poor nutrition and low sunlight exposure. This study aimed to evaluate the prevalence of 25-hydroxyvitamin (25(OH)D) deficiency and supplementation and to investigate their association with adverse health outcomes in geriatric rehabilitation inpatients.

Design

Prospective, observational and longitudinal study.

Setting and Participants

Geriatric rehabilitation inpatients admitted to geriatric rehabilitation wards at the Royal Melbourne Hospital (Melbourne, Australia) from 16th, October 2017 and discharged until 18th, March 2020 in the REStORing health of acutely unwell adulTs (RESORT) study were included.

Methods

25(OH)D levels measured close to rehabilitation admission were classified as sufficiency (>54 nmol/L), insufficiency (26–54 nmol/L), or deficiency (<26 nmol/L). The usage of vitamin D supplementation was extracted from medication records. Outcomes included incidence of institutionalization at three-month post-discharge, in-hospital mortality and post-discharge mortality.

Results

The median age of 1328 geriatric rehabilitation inpatients was 83.9 years (IQR: 78.1–88.7, 58.6% female). 25(OH)D deficiency and insufficiency were present in 8.1% and 26.4% of inpatients, respectively; 74.2% used vitamin D supplementation. 25(OH)D deficiency was associated with higher odds of institutionalization (odds ratio (OR): 1.88, 95% confidence interval (CI): 1.14–3.11), in-hospital mortality (OR: 3.30, 95% CI: 1.54–7.07) and higher risks of one-year mortality (hazard ratio (HR): 1.77, 95% CI: 1.17–2.69) compared to 25(OH)D sufficiency but not with three-month mortality. 25(OH)D insufficiency was not associated with outcomes. Patients who did not use supplementation and had 25(OH)D insufficiency or deficiency had significantly higher in-hospital mortality compared to those who used supplementation.

Conclusions

Among geriatric rehabilitation inpatients, 25(OH) D deficiency was associated with institutionalization, in-hospital mortality and one-year mortality. Attention to monitor the vitamin D status is of upmost importance during hospitalization.

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Acknowledgment

We thank all members from the multidisciplinary clinical team of the Royal Melbourne Hospital and the @AgeMelbourne team for their involvement in the RESORT study and assistance in the data collection. We would also like to thank the Department of Pathology, the Royal Melbourne Hospital for assessing the vitamin D data.

Funding

Funding sources: This work was funded by the University of Melbourne and the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH).

Author information

Authors and Affiliations

  1. Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia

    L. Guan, E. M. Reijnierse & Andrea B. Maier

  2. Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands

    E. M. Reijnierse

  3. Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit, Amsterdam Movement Sciences, Amsterdam, the Netherlands

    Andrea B. Maier

  4. Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    L. Guan & Andrea B. Maier

  5. Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore

    L. Guan & Andrea B. Maier

  6. Department of Medicine and Aged Care, @Age, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands

    Andrea B. Maier

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  1. L. Guan
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Corresponding author

Correspondence to Andrea B. Maier.

Ethics declarations

Conflict of interest: All authors declare no conflict of interest.

Ethical standard: All patients or their nominated proxy provided written informed consent. This study was approved by the Melbourne Health Human Research Ethics Committee (No.: HREC/16/MH/346) and was conducted in agreement with the Declaration of Helsinki and the National Statement on Ethical Conduct in Human Research.

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Guan, L., Reijnierse, E.M. & Maier, A.B. Associations of 25-Hydroxyvitamin D Status and Supplementation with Adverse Outcomes in Geriatric Rehabilitation Inpatients: RESORT. J Nutr Health Aging 27, 1206–1211 (2023). https://doi.org/10.1007/s12603-023-2021-y

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  • DOI: https://doi.org/10.1007/s12603-023-2021-y

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