Vitamin D and Bone Health of Older Adults within Care Homes: An Observational Study

Limited studies have reported vitamin D status and health outcomes in care home residents, a group at risk of vitamin D deficiency. This study investigated serum 25-hydroxyvitamin D (25-OHD) concentrations in older adults within care homes in Northern Ireland (NI) and its association with musculoskeletal health (ultrasound T-score, muscle strength, Timed Up & Go test (TUG)), bone turnover markers (BTMs), and immune function markers. A total of 87 participants were recruited with mean +/- SD age 83.2 +/- 7.9 years. Mean +/- SD serum 25-OHD concentration (n 69) was 49.52 +/- 35.58 nmol/L. Vitamin D deficiency (25-OHD <25 nmol/L) was observed in 34.8% (n 24) of participants with 17.4% (n 12) classified as insufficient (25-OHD 25-50 nmol/L) and 47.8% (n 33) as sufficient (25-OHD >50 nmol/L). 25-OHD concentration was not an independent predictor of T-score, muscle strength, TUG, or inflammatory cytokines. After adjusting for covariates, a significant negative association was observed between 25-OHD concentration and the BTMs; osteocalcin (beta = -0.395; p = 0.001), procollagen type 1 N propeptide (P1NP) (beta = -0.320; p = 0.012), and C-terminal telopeptide of type 1 collagen (CTX) (beta = -0.377; p = 0.003). Higher 25-OHD concentration was positively associated with use of vitamin D +/- calcium supplementation (beta = 0.610; p < 0.001). Vitamin D deficiency and insufficiency were highly prevalent in this sample of care home residents in NI. Higher 25-OHD concentration was associated with greater supplement use and with reduced bone turnover, which in this population is linked with reduced bone loss. These findings emphasize the need for a mandatory vitamin D +/- calcium supplementation policy specific for care home residents.