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Vitamin D in older people

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  01 November 2008

Ian C Logan  and
Miles D Witham
Ian C Logan
Affiliation:
Section of Ageing and Health, Ninewells Hospital, Dundee, Scotland
Miles D Witham*
Affiliation:
Section of Ageing and Health, Ninewells Hospital, Dundee, Scotland
*
Address for correspondence: Miles Witham, Section of Ageing and Health, Ninewells Hospital, Dundee DD1 9SY, UK. Email: m.witham@dundee.ac.uk
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Extract

Vitamin D has been known to play a key role in calcium homeostasis and bone health for almost a century. Its main current clinical use is as an agent to prevent osteomalacia and reduce fragility fractures in older people. Vitamin D may however play a wider physiological role, with effects on cancer prevention, cardiovascular health and immune function. This review article will outline the physiological role of vitamin D, the disease processes that have been associated with insufficiency and examine whether vitamin D supplementation can ameliorate these disease processes in older people.

Information

Type
Clinical gerontology
Information
Reviews in Clinical Gerontology , Volume 18 , Issue 4 , November 2008 , pp. 287 - 298
Copyright
Copyright © Cambridge University Press 2009

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References

1Lamberg-Allardt, C. Vitamin D in foods and as supplements. Prog Biophys Mol Biol 2006; 92: 33–8.CrossRefGoogle ScholarPubMed
2Jones, G, Strugnell, SA, DeLuca, HF. Current understanding of the molecular actions of vitamin D. Physiol Rev 1998; 78: 1193–231.CrossRefGoogle ScholarPubMed
3Norman AW, , Okamura, WH, Bishop, JE, Henry, HL. Update on biological actions of 1alpha,25(OH)2-vitamin D3 (rapid effects) and 24R,25(OH)2-vitamin D3. Mol Cell Endocrinol 2002; 197: 1–13.CrossRefGoogle Scholar
4Norman, AW. From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr 2008; 88: 491S–9S.CrossRefGoogle ScholarPubMed
5Bischoff-Ferrari, HA, Giovannucci, E, Willett, WC, Dietrich, T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006; 84: 18–28.CrossRefGoogle ScholarPubMed
6Vieth, R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999; 69: 842–56.CrossRefGoogle ScholarPubMed
7Preece, MA, Tomlinson, S, Ribot, CA et al. Studies of vitamin D deficiency in man. QJM 1975; 44: 575–89.Google ScholarPubMed
8Maxwell, JD. Seasonal variation in vitamin D. Proc Nutr Soc 1994; 53: 533–43.CrossRefGoogle ScholarPubMed
9Hypponen, E, Power, C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr 2007; 85: 860–8.CrossRefGoogle ScholarPubMed
10Hirani, V, Primatesta, P. Vitamin D concentrations among people aged 65 years and over living in private households and institutions in England: population survey. Age Ageing 2005; 34: 485–91.CrossRefGoogle ScholarPubMed
11Francis, RM, Anderson, FH, Patel, S, Sahota, O, van Staa, TP. Calcium and vitamin D in the prevention of osteoporotic fractures. QJM 2006; 99: 355–63.CrossRefGoogle ScholarPubMed
12Dhesi, JK, Moniz, C, Close, JC, Jackson, SH, Allain, TJ. A rationale for vitamin D prescribing in a falls clinic population. Age Ageing 2002; 31: 267–71.CrossRefGoogle Scholar
13Pfeifer, M, Begerow, B, Minne, HW. Vitamin D and muscle function. Osteoporos Int 2002; 13: 187–94.CrossRefGoogle ScholarPubMed
14Janssen, HC, Samson, MM, Verhaar, HJ. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr 2002; 75: 611–5.CrossRefGoogle ScholarPubMed
15Douglas, AS, Dunnigan, MG, Allan, TM, Rawles, JM. Seasonal variation in coronary heart disease in Scotland. J Epidemiol Community Health 1995; 49: 575–82.CrossRefGoogle ScholarPubMed
16Enquselassie, F, Dobson, AJ, Alexander, HM, Steele, PL. Seasons, temperature and coronary disease. Int J Epidemiol 1993; 22: 632–6.CrossRefGoogle ScholarPubMed
17Giovannucci, E, Liu, Y, Hollis, BW, Rimm, EB. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 2008; 168: 1174–80.CrossRefGoogle Scholar
18Barakat, K, Hitman, GA. The emerging role of vitamin D and its receptor in the pathogenesis of acute coronary syndromes. Br J Cardiol 2006; 13: 9–12.Google Scholar
19Watson, KE, Abrolat, ML, Malone, LL et al. Active serum vitamin D levels are inversely correlated with coronary calcification. Circulation 1997; 96: 1755–60.CrossRefGoogle ScholarPubMed
20Scragg, R, Sowers, M, Bell, C. Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 2007; 20: 713–9.CrossRefGoogle ScholarPubMed
21Forman, JP, Giovannucci, E, Holmes, MD et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension 2007; 49: 1063–9.CrossRefGoogle ScholarPubMed
22Sigmund, CD. Regulation of renin expression and blood pressure by vitamin D(3). J Clin Invest 2002; 110: 155–6.CrossRefGoogle ScholarPubMed
23Wang, TJ, Pencina, MJ, Booth, SL et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008; 117: 503–11.CrossRefGoogle ScholarPubMed
24Hypponen, E, Boucher, BJ, Berry, DJ, Power, C. 25-Hydroxyvitamin D, IGF-1, and metabolic syndrome at 45 years of age: a cross-sectional study in the 1958 British Birth Cohort. Diabetes 2008; 57: 298–305.CrossRefGoogle ScholarPubMed
25Scragg, R, Holdaway, I, Singh, V, Metcalf, P, Baker, J, Dryson, E. Serum 25-hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus. Diabetes Res Clin Pract 1995; 27: 181–8.CrossRefGoogle ScholarPubMed
26Ponsonby, AL, Pezic, A, Ellis, J et al. Variation in associations between allelic variants of the vitamin D receptor gene and onset of type 1 diabetes mellitus by ambient winter ultraviolet radiation levels: a meta-regression analysis. Am J Epidemiol 2008; 168: 358–65.CrossRefGoogle Scholar
27Poole, KE, Loveridge, N, Barker, PJ et al. Reduced vitamin D in acute stroke. Stroke 2006; 37: 243–5.CrossRefGoogle ScholarPubMed
28Zittermann, A, Schleithoff, SS, Tenderich, G, Berthold, HK, Korfer, R, Stehle, P. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 2003; 41: 105–12.CrossRefGoogle ScholarPubMed
29Shane, E, Mancini, D, Aaronson, K et al. Bone mass, vitamin D deficiency, and hyperparathyroidism in congestive heart failure. Am J Med 1997; 103: 197–207.CrossRefGoogle ScholarPubMed
30Black, PN, Scragg, R. Relationship between serum 25-hydroxyvitamin D and pulmonary function in the third national health and nutrition examination survey. Chest 2005; 128: 3792–8.CrossRefGoogle ScholarPubMed
31Wright, RJ. Make no bones about it: increasing epidemiologic evidence links vitamin D to pulmonary function and COPD. Chest 2005; 128: 3781–3.CrossRefGoogle ScholarPubMed
32Lappe, JM, Travers-Gustafson, D, Davies, KM, Recker, RR, Heaney, RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007; 85: 1586–91.CrossRefGoogle ScholarPubMed
33Parekh, N, Chappell, RJ, Millen, AE, Albert, DM, Mares, JA. Association between vitamin D and age-related macular degeneration in the Third National Health and Nutrition Examination Survey, 1988 through 1994. Arch Ophthalmol 2007; 125: 661–9.CrossRefGoogle ScholarPubMed
34Dietrich, T, Joshipura, KJ, Dawson-Hughes, B, Bischoff-Ferrari, HA. Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr 2004; 80: 108–13.Google ScholarPubMed
35Berk, M, Sanders, KM, Pasco, JA et al. Vitamin D deficiency may play a role in depression. Med Hypotheses 2007; 69: 1316–9.CrossRefGoogle ScholarPubMed
36Jorde, R, Sneve, M, Figenschau, Y, Svartberg, J, Waterloo, K. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med 2008; 264: 599–609.CrossRefGoogle ScholarPubMed
37Przybelski, RJ, Binkley, NC. Is vitamin D important for preserving cognition? A positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function. Arch Biochem Biophys 2007; 460: 202–5.CrossRefGoogle Scholar
38Avenell, A, Gillespie, WJ, Gillespie, LD, O'Connell, DL. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev 2005; CD000227.CrossRefGoogle Scholar
39Grant, AM, Avenell, A, Campbell, MK et al. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 2005; 365: 1621–8.Google ScholarPubMed
40Burleigh, E, McColl, J, Potter, J. Does vitamin D stop inpatients falling? A randomised controlled trial. Age Ageing 2007; 36: 507–13.CrossRefGoogle ScholarPubMed
41Lind, L, Wengle, B, Wide, L, Ljunghall, S. Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo-controlled study. Am J Hypertens 1989; 2: 20–5.CrossRefGoogle ScholarPubMed
42Lind, L, Wengle, B, Ljunghall, S. Blood pressure is lowered by vitamin D (alphacalcidol) during long-term treatment of patients with intermittent hypercalcaemia. A double-blind, placebo-controlled study. Acta Med Scand 1987; 222: 423–7.CrossRefGoogle ScholarPubMed
43Krause, R, Buhring, M, Hopfenmuller, W, Holick, MF, Sharma, AM. Ultraviolet B and blood pressure. Lancet 1998; 352: 709–10.CrossRefGoogle ScholarPubMed
44Pfeifer, M, Begerow, B, Minne, HW, Nachtigall, D, Hansen, C. Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab 2001; 86: 1633–7.Google ScholarPubMed
45Scragg, R, Khaw, KT, Murphy, S. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr 1995; 49: 640–6.Google ScholarPubMed
46Timms, PM, Mannan, N, Hitman, GA et al. Circulating MMP9, vitamin D and variation in the TIMP-1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders? QJM 2002; 95: 787–96.CrossRefGoogle ScholarPubMed
47Van Den, BG, Van Roosbroeck, D, Vanhove, P, Wouters, PJ, De Pourcq, L, Bouillon, R. Bone turnover in prolonged critical illness: effect of vitamin D. J Clin Endocrinol Metab 2003; 88: 4623–32.CrossRefGoogle Scholar
48Trivedi, DP, Doll, R, Khaw, KT. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 2003; 326: 469.CrossRefGoogle ScholarPubMed
49Hsia, J, Heiss, G, Ren, H et al. Calcium/vitamin D supplementation and cardiovascular events. Circulation 2007; 115: 846–54.CrossRefGoogle ScholarPubMed
50Schleithoff, SS, Zittermann, A, Tenderich, G, Berthold, HK, Stehle, P, Koerfer, R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2006; 83: 754–9.CrossRefGoogle ScholarPubMed
51Sugden, JA, Davies, JI, Witham, MD, Morris, AD, Struthers, AD. Vitamin D improves endothelial function in patients with type 2 diabetes mellitus and low vitamin D levels. Diab Med 2008; 25: 320–5.CrossRefGoogle ScholarPubMed
52Avenell, A, Cook, JA, Maclennan, GS, Macpherson, GC. Vitamin D supplementation to prevent infections: a sub-study of a randomised placebo-controlled trial in older people (RECORD trial, ISRCTN 51647438). Age Ageing 2007; 36: 574–7.CrossRefGoogle ScholarPubMed
53Avenell, A, Campbell, MK, Cook, JA et al. Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial. BMJ 2005; 331: 324–9.CrossRefGoogle ScholarPubMed
54Wactawski-Wende, J, Kotchen, JM, Anderson, GL et al. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006; 354: 684–96.CrossRefGoogle ScholarPubMed
55Autier, P, Gandini, S. Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med 2007; 167: 1730–7.CrossRefGoogle ScholarPubMed
56Corless, D, Dawson, E, Fraser, F et al. Do vitamin D supplements improve the physical capabilities of elderly hospital patients? Age Ageing 1985; 14: 76–84.CrossRefGoogle ScholarPubMed
57Latham, NK, Anderson, CS, Lee, A, Bennett, DA, Moseley, A, Cameron, ID. A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc 2003; 51: 291–9.CrossRefGoogle ScholarPubMed
58Jackson, RD, LaCroix, AZ, Gass, M et al. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 2006; 354: 669–83.CrossRefGoogle ScholarPubMed
59Rajasree, S, Rajpal, K, Kartha, CC et al. Serum 25-hydroxyvitamin D3 levels are elevated in South Indian patients with ischemic heart disease. Eur J Epidemiol 2001; 17: 567–71.CrossRefGoogle ScholarPubMed
60Gale, CR, Robinson, SM, Harvey, NC et al. Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr 2008; 62: 68–77.CrossRefGoogle ScholarPubMed
61Hypponen, E, Berry, DJ, Wjst, M, Power, C. Serum 25-hydroxyvitamin D and IgE – a significant but nonlinear relationship. Allergy 2009; 64: 613–20.CrossRefGoogle Scholar
62Romagnoli, E, Mascia, ML, Cipriani, C et al. Short and long-term variations in serum calciotropic hormones after a single very large dose of ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) in the elderly. J Clin Endocrinol Metab 2008; 93: 3015–20.CrossRefGoogle ScholarPubMed
63Smith, H, Anderson, F, Raphael, H, Maslin, P, Crozier, S, Cooper, C. Effect of annual intramuscular vitamin D on fracture risk in elderly men and women – a population-based, randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford) 2007; 46: 1852–7.CrossRefGoogle ScholarPubMed
64Aloia, JF, Patel, M, Dimaano, R et al. Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration. Am J Clin Nutr 2008; 87: 1952–8.CrossRefGoogle ScholarPubMed
65Chel, V, Wijnhoven, HA, Smit, JH, Ooms, M, Lips, P. Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents. Osteoporos Int 2008; 19: 663–71.CrossRefGoogle ScholarPubMed
66Holick, MF, Biancuzzo, RM, Chen, TC et al. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. J Clin Endocrinol Metab 2008; 93: 677–81.CrossRefGoogle Scholar
67Jean, G, Terrat, JC, Vanel, T et al. Evidence for persistent vitamin D 1-alpha-hydroxylation in hemodialysis patients: evolution of serum 1,25-dihydroxycholecalciferol after 6 months of 25-hydroxycholecalciferol treatment. Nephron Clin Pract 2008; 110: c58–65.CrossRefGoogle ScholarPubMed
68Ilahi, M, Armas, LA, Heaney, RP. Pharmacokinetics of a single, large dose of cholecalciferol. Am J Clin Nutr 2008; 87: 688–91.CrossRefGoogle ScholarPubMed
69Talwar, SA, Aloia, JF, Pollack, S, Yeh, JK. Dose response to vitamin D supplementation among postmenopausal African American women. Am J Clin Nutr 2007; 86: 1657–62.CrossRefGoogle ScholarPubMed
70Viljakainen, HT, Palssa, A, Karkkainen, M, Jakobsen, J, Lamberg-Allardt, C. How much vitamin D3 do the elderly need? J Am Coll Nutr 2006; 25: 429–35.CrossRefGoogle ScholarPubMed
71Ryan, PJ. Vitamin D therapy in clinical practice. One dose does not fit all. Int J Clin Pract 2007; 61: 1894–9.CrossRefGoogle Scholar
72Leventis, P, Kiely, PD. The tolerability and biochemical effects of high-dose bolus vitamin D2 and D3 supplementation in patients with vitamin D insufficiency. Scand J Rheumatol 2009; 38: 149–53.CrossRefGoogle ScholarPubMed