Low Vitamin D Levels Linked to Increased Disability Risk

Having lower levels of vitamin D in the blood may increase the risk of disability and impaired mobility in older adults, according to a study.

Vitamin D is found in many dietary sources, such as fish, eggs, fortified milk and cod liver oil. The sun also contributes significantly to the daily production of vitamin D, and as little as 10 minutes of exposure is thought to be enough to prevent deficiencies. The term "vitamin D" refers to several different forms of this vitamin. Two forms are important in humans: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D2 is synthesized by plants. Vitamin D3 is synthesized by humans in the skin when it is exposed to ultraviolet B (UVB) rays from sunlight. Foods may be fortified with vitamin D2 or D3.

In a new study, researchers evaluated 3,705 well-functioning men and women aged 70-79 years-old who were participating in the Health, Aging and Body Composition Study. Over a six-year period, the team measured subjects' vitamin D levels and mobility status semi-annually to determine if the two may be linked. The participants performed tasks such as walking a quarter of a mile, climbing 10 steps or engaging in other everyday tasks to determine their level of physical function.

The results suggested that people who had lower vitamin D levels had about a 30 percent greater risk of experiencing mobility limitations and about a twofold greater risk of disability, compared to those who had higher levels of vitamin D.

The scientists concluded that increasing vitamin D intake may help older adults maintain mobility and prevent the development of physical disability. More research is needed to better understand these findings.

The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. It is used, alone or in combination with calcium, to increase bone mineral density and decrease fractures. Recently, research also suggests that vitamin D may provide protection from osteoporosis, hypertension (high blood pressure), cancer and several autoimmune diseases.

For more information about vitamin D, please visit Natural Standard's Foods, Herbs & Supplements Database.

Comments

[nh]

This study showing a link to low vitamin D levels and increase disability risk is very interesting. Reading this I wonder if it having low vitamin D that causes increased risk or if the patient already has disability and thus has decreased vitamin D level. I wonder this because sun light is one of the best sources of vitamin D and if you are disabled you probably is not getting a lot of sunlight. You are also probably not eating a good rounded diet so you might not be getting vitamin through your diet. Hopefully, there is continued research in this area.

[AF1]

When I first started reading about this article, I immediately started relating the effects of vitamin d to calcium absorption and overall bone health. I still think there is some correlation as to why these individuals would become disabled solely based on that. I'm not sure that it is a fair assumption to say that low levels of vitamin d are to blame for the increased risk of disability, simply because these things all go hand-in-hand. Obviously if they have low vitamin D they are probably going to have low calcium as well, so that is something to look into. There are many factors playing a part here.

[ee]

I like the fact that this article promotes the concomitant use of vitamin D and calcium in the elderly to help in the absorption of calcium for better bone health. However, I have had patients in the pharmacy complain about the once weekly dosing of prescription vitamin D3 because they forget if they had taken it that week or not. A pharmacist usually recommend they drink vitamin D milk, but in a recent article, the nutritional value of milk in adults has been put under scrutiny, I wonder what alternatives the elderly will have other than the OTC and prescription vitamin D currently available?
Very interesting article.

[UP]

This is very interesting. I know several people in my culture that avoid being out in the sun because they do not want to get “darker” or tan because fairness is prized and don’t eat meats, eggs, or fish. These same people are now having problems with walking and are using walking canes and walkers at the age of 60. It would be interesting to see how their vitamin D levels compared to those that do walk outside or have a more balanced diet.

[gwanbobmuga-gdc]

It is always good to pay attention to whatever you are eating. Common Vitamin D foods include dairy products, meat, eggs, and fish. Sardine which is cheap, beef liver and salmon are great sources of vitamin D. Although these foods are good sources, they cannot replace exposure to sunlight. It is always helpful to note that eating these foods will be good to provide your body with some level of vitamin D, but it won’t be enough to meet up with your daily requirements. Another important thing to note is that vitamin D deficiency may go without notice. You think you are feeling perfectly fine right? But it will be wise to spend sometime in the sun and eat the foods mentioned above. It is very easy for Vitamin D deficiency symptoms to be misleading. Depression is one of the symptoms of chronic vitamin D deficiency. But there are also other differential diagnoses. Practice living a healthy life-style and take care of your body. It’s all you’ve got.

[RJD]

It seems to me that with all of the controversy around vitamin D supplementation we should work on increasing our vitamin D levels more naturally. Taking a short walk around the block at lunch break or before dinner would be a great way to increase vitamin D and get some exercise. If it is hard to take a walk try sitting outside on the porch at home or at a restaurant (if they have one). But always be careful of getting too much sun exposure and if you are going to be outside for a while put sunscreen on.

[Emily]

The safety and effectiveness of Vitamin D supplementation are still quite a conundrum. Although some studies like this one indicate their effectiveness, others indicate that the harm associated is not worth it. Natural Standard's monograph states that too much Vitamin D may increase people's risk for hypercalcemia and kidney stones, and a recent Natural Standard news story discusses a study in which high levels of Vitamin D were associated with a higher risk of mortality among study participants. The U.S. Preventive Services Task Force now recommends against Vitamin D supplementation.

[Melissa Nguyen]

Also it's important to recommend screening for older adults greater than 65 years of age, or those less than 65 with more than 1 risk factor for osteoporosis. We should encourage patients to talk to their pharmacist or other health care practitioner about assessing risk for osteoporosis and bone fracture using the FRAX tool. We should also encourage patients to talk to their doctor about getting a bone density scan (DXA scan). Patients should empower themselves and be aware of their health status!

[Melissa Nguyen]

This is a great topic for discussion because many people, older adults in particular, are at risk for decreased vitamin D levels. This could be partially because as the skin ages, it becomes less efficient in making vitamin D from the sun. Other factors might be the increased time spent indoors, and inadequate dietary intake. Vitamin D, as mentioned in this blog entry, is helpful in the absorption of calcium, and thus is important in keeping our bones strong and healthy. It's important to your doctor or pharmacist to see if you need to supplement vitamin D and calcium in your diet to prevent osteoporosis (weak bones) and fractures in the future.

[MW]

I really hope this is something that "catches on" in the medical community. All older adults, especially 70+ and with risk factors, should be on calcium and vitamin D supplementation. Naturally as we get older our bones become weaker and our fall risk increase. I completed my last rotation in Long Term Care and the number 1 worry in a nursing home is always patient falls. Unfortunately falls are something that happens as we get older. Giving calcium and vitamin D supplementation will allow older adults to have stronger bones so when that fall eventually does happen they will only have bruises not broken bones. I believe every older adult 65+ should be on regular calcium and vitamin D supplements unless there is a specific reason to not do so.

[CL]

Since vitamin D is related to bone health, I’m not surprised by the results of this study. A deficiency of vitamin D can lead to weaker bones and this can cause the immobility. This is a problem in the northeast where patients are constantly being prescribed vitamin D supplements because of the lack of sunlight. Fortunately vitamin D is found in a lot of food sources now so hopefully the risk of deficiency is less

[Erica Marini]

Vitamin D has been in the news a lot recently- there seems to be no end to its health benefits. In the specific case of osteoporosis, it's been very interesting to see how practice has changed from reliance on calcium to now knowing that adequate Vitamin D is more important for bone health.

[LT]

This discussion on Vitamin D is very interesting. I feel that Vitamin D is used for so many things. There has been a study recently that suggests a higher level of Vitamin D is associated with a decreased in colon cancer. It will be interesting to see what further uses of Vitamin D are discovered in the future. The study mentioned in this article is good to know in order to counsel patients with a history of osteoporosis.