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Serum 25-hydroxyvitamin D concentration and its determinants in the very old: the Newcastle 85+ Study

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Abstract

Summary

Data on vitamin D status in very old adults are lacking. The aim of this study was to assess 25-hydroxyvitamin D [25(OH)D] concentrations and its predictors in 775 adults aged 85 years old living in North-East England. Low 25(OH)D was alarmingly high during winter/spring months, but its biological significance is unknown.

Introduction

Despite recent concerns about the high prevalence of vitamin D deficiency in much of the British adult and paediatric population, there is a dearth of data on vitamin D status and its predictors in very old adults. The objective of the present study was to describe vitamin D status and its associated factors in a broadly representative sample of very old men and women aged 85 years living in the North East of England (55° N).

Methods

Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were analysed in 775 participants in the baseline phase of the Newcastle 85+ cohort study. Season of blood sampling, dietary, health, lifestyle and anthropometric data were collected and included as potential predictors of vitamin D status in ordinal regression models.

Results

Median serum 25(OH)D concentrations were 27, 45, 43 and 33 nmol/L during spring, summer, autumn and winter, respectively. The prevalence of vitamin D deficiency according to North American Institute of Medicine guidelines [serum 25(OH)D <30 nmol/L] varied significantly with season with the highest prevalence observed in spring (51 %) and the lowest prevalence observed in autumn (23 %; P < 0.001). Reported median (inter-quartile range) dietary intakes of vitamin D were very low at 2.9 (1.2–3.3) μg/day. In multivariate ordinal regression models, non-users of either prescribed or non-prescribed vitamin D preparations and winter and spring blood sampling were associated with lower 25(OH)D concentrations. Dietary vitamin D intake, disability score and disease count were not independently associated with vitamin D status in the cohort.

Conclusion

There is an alarming high prevalence of vitamin D deficiency (<30 nmol/L) in 85-year-olds living in North East England at all times of the year but particularly during winter and spring. Use of vitamin D containing preparations (both supplements and medications) appeared to be the strongest predictor of 25(OH)D concentrations in these very old adults.

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Acknowledgments

The Newcastle 85+ Study has been funded by the Medical Research Council, Biotechnology and Biological Sciences Research Council, the Dunhill Medical Trust, Newcastle University, and the North of England Commissioning Support Unit (formerly NHS North of Tyne). The research was also supported by the National Institute for Health Research Newcastle Biomedical Research Centre, based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University. Additional work was also supported by the British Heart Foundation and Unilever Corporate Research. We acknowledge the operational support of the North of England Commissioning Support Unit and the local general practitioners and their staff. We thank the research, management and clerical team for outstanding work throughout. Thanks are due especially to the study participants and, where appropriate, their families and carers.

Author information

Authors and Affiliations

  1. Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK

    T. R. Hill, A. Granic, K. Davies, J. Collerton, C. Martin-Ruiz, M. Siervo, J. C. Mathers, A. J. Adamson, R. M. Francis, T. B. L. Kirkwood & C. Jagger

  2. School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK

    T. R. Hill

  3. Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK

    T. R. Hill, M. Siervo, J. C. Mathers & A. J. Adamson

  4. Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK

    M. Siervo, J. C. Mathers & R. M. Francis

  5. Institute for Health and Society, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK

    A. Granic, K. Davies, A. J. Adamson & C. Jagger

  6. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK

    C. Martin-Ruiz

  7. Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK

    S. H. Pearce & S. Razvi

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Corresponding author

Correspondence to T. R. Hill.

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Competing interests

TRH, AG, KD, JC, CM-R, MS, JCM, AJA, SHP, SR, TBLK, and CJ have no conflicts of interest. RMF is a member of the UK Department of Health Scientific Advisory Committee on Nutrition (SACN) Working Group on Vitamin D and is Chair of the Writing Group for UK National Osteoporosis Society Practical Clinical Guideline for Patient Management on Vitamin D and Bone Health. He has also received speaker’s honoraria from Shire Pharmaceuticals, who markets calcium and vitamin D supplements. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the organizations they work with.

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Hill, T.R., Granic, A., Davies, K. et al. Serum 25-hydroxyvitamin D concentration and its determinants in the very old: the Newcastle 85+ Study. Osteoporos Int 27, 1199–1208 (2016). https://doi.org/10.1007/s00198-015-3366-9

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