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Prevalence of Vitamin D Deficiency and Association with Functional Status in Newly Admitted Male Veteran Nursing Home Residents

Authors

  • Gotaro Kojima MD,

    Corresponding author
    1. Community Living Center, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
    2. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
    • Address correspondence Gotaro Kojima, MD, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, 347 N. Kuakini Street HPM-9, Honolulu, HI 96817. E-mail: gotarokojima@yahoo.co.jp

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  • Anna Tamai MD,

    1. Community Living Center, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
    2. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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  • Kamal Masaki MD,

    1. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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  • Gregory Gatchell DO,

    1. Community Living Center, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
    2. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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  • James Epure MD,

    1. Community Living Center, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
    2. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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  • Craig China MD,

    1. Community Living Center, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
    2. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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  • G. Webster Ross MD,

    1. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
    2. Pacific Health Research and Education Institute, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
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  • Helen Petrovitch MD,

    1. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
    2. Pacific Health Research and Education Institute, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
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  • Marianne Tanabe MD

    1. Community Living Center, Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii
    2. Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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Abstract

Objectives

To provide the first report on prevalence of vitamin D deficiency in newly admitted nursing home (NH) residents and associations with functional disabilities and chronic diseases.

Design

Retrospective chart review.

Setting

Nursing home (NH).

Participants

Male veterans newly admitted to a NH for rehabilitation, skilled-nursing care, intermediate care, or respite care between January 2011 and June 2012.

Measurements

Total serum 25-hydroxyvitamin D (25(OH)D) levels were measured on admission. Vitamin D supplement users and those without 25(OH)D measurement within 7 days of admission were excluded, leaving an analytical sample of 104 residents. Vitamin D deficiency was defined as 25(OH)D less than 20 ng/mL. Data were collected on age, ethnicity, season, body mass index (BMI), functional disability in activities of daily living (ADLs) (mobility, bathing, dressing, toileting, continence, and feeding), and prevalent chronic diseases.

Results

Prevalence of vitamin D deficiency was 49.0%. In multivariate logistic regression models adjusted for age, ethnicity, and BMI, vitamin D deficiency was significantly associated with number of ADL disabilities (odds ratio (OR) = 1.4 for each 1-point increase in ADL disability score, P = .03) and prevalent diabetes mellitus (OR = 3.0, P = .03). In regression models using each ADL disability as a separate variable, only disability in feeding (OR = 4.7, P = .05) and diabetes mellitus (OR = 2.9, P = .04) remained significant.

Conclusion

Almost half the individuals entering the NH and not taking vitamin D supplements had vitamin D deficiency. Greater number of ADL disabilities, disability in feeding, and prevalent diabetes mellitus were independently associated with vitamin D deficiency.

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