Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission.

Background: The prevalence of vitamin D deficiency in nursing home patients is high. Objective: We aimed to ascertain whether lower serum 25hydroxyvitamin D [25(OH)D] concentrations increase the risk of future nursing home admission and early death. Design: We included 1260 independent, community-dwelling persons aged 65 y who were participating in the Longitudinal Aging Study Amsterdam (1995–1996). Study outcomes were time to nursing home admission durin g6yo ffollow-up and time to death until 1 April 2003. Results: Vitamin D deficiency [25(OH)D 25 nmol/L] and insufficiency[25(OH)D25–49.9nmol/L]werepresentin127(10.1%) and 462 (36.7%) subjects, respectively. During follow-up, 138 subjects (11.0%) were admitted to nursing homes, and 380 subjects (30.2%) died. The risk of nursing home admission for participants with25(OH)Ddeficiencywas53casesper1000person-yearshigher thanthatforthosewithhigh25(OH)D(75nmol/L)concentrations (58 compared with 5 cases). After adjustment for potential confounders, the hazard ratio (95% CI) of nursing home admission was 3.48 (1.39, 8.75) for vitamin D–deficient, 2.77 (1.17, 6.55) for vitaminD–insufficient,and1.92(0.79,4.66)forvitaminD–borderline persons as compared with persons with high 25(OH)D (P for trend0.002).Theresultsremainedafteradditionaladjustmentfor frailty indicators. Lower 25(OH)D was associated with higher mortality risk, but this association was not significant after adjustment for frailty indicators. Conclusion: Lower serum 25(OH)D concentrations in older persons are associated with a greater risk of future nursing home admission and may be associated with mortality. Am J Clin Nutr 2006;84:616–22.