25(OH) vitamin D and functional outcomes in older adults admitted to rehabilitation units: the safari study.


Journal

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 08 06 2018
accepted: 04 01 2019
pubmed: 18 1 2019
medline: 18 12 2019
entrez: 18 1 2019
Statut: ppublish

Résumé

Vitamin D (25(OH)D) deficiency is associated with poor physical performance; little is known about its impact on geriatric rehabilitation. We found a positive non-linear relationship between 25(OH)D and functional gain, stronger in levels < 16 ng/ml (below the cutoff for "deficiency"). An early 25(OH)D dosage may be advisable for this population. Vitamin D (25(OH)D) deficiency is highly prevalent in older people, and it is associated with poor muscular strength and physical performance. Its impact on functional outcomes during geriatric rehabilitation has been poorly studied. We aim to analyze the association between 25(OH)D and functional recovery in geriatric rehabilitation units. We conducted a prospective multi-center cohort study including patients ≥ 65 years old admitted to 3 geriatric rehabilitation units in Italy and Spain, after orthopedic events or stroke. Outcomes were absolute functional gain (AFG, discharge-admission Barthel index) and ability to walk (AW) at 3 months after admission. The association between 25(OH)D quartiles (Q1-Q2-Q3-Q4) and outcomes was explored using linear or logistic regression models. We included 420 patients (mean age = 81.2 years [SD = 7.7], 66.4% females, mean 25(OH)D concentration = 13.5 ng/ml [SD = 8.7]) (to convert to nmol/l multiply by 2.496). A non-linear relationship between 25(OH)D and AFG was found, with a stronger association for 25(OH)D levels < 16 ng/ml. Compared to Q1 (25(OH)D ≤ 6 ng/ml), participants in Q3 (25(OH)D 11.5-18.2 ng/ml) had the best AFG and AW (mean AFG [SD], Q1 = 28.9 [27.8], Q2 = 32.5 [23.5], Q3 = 43.1 [21.9], Q4 = 34.5 [29.3], R In our study, 25(OH)D concentration showed a positive association with functional outcomes at 3 months. The association is stronger below the usual cutoff for "deficiency." Dosage of 25(OH)D concentration may help identify geriatric rehabilitation patients at risk for a worse functional recovery.

Identifiants

pubmed: 30652217
doi: 10.1007/s00198-019-04845-7
pii: 10.1007/s00198-019-04845-7
doi:

Substances chimiques

Vitamin D 1406-16-2
25-hydroxyvitamin D A288AR3C9H

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

887-895

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Auteurs

D Lelli (D)

Area di Geriatria, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy. d.lelli@unicampus.it.

L M Pérez Bazan (LM)

Parc Sanitari Pere Virgili, Barcelona, Spain.
Vall d'Hebrón Institute of Research, Barcelona, Spain.

A Calle Egusquiza (A)

Parc Sanitari Pere Virgili, Barcelona, Spain.
Vall d'Hebrón Institute of Research, Barcelona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.

G Onder (G)

Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy.

A Morandi (A)

Department of Rehabilitation and Aged Care of the Fondazione Camplani, Ancelle Hospital, Cremona, Italy.

E Ortolani (E)

Department of Rehabilitation and Aged Care of the Fondazione Camplani, Ancelle Hospital, Cremona, Italy.

M Mesas Cervilla (M)

Parc Sanitari Pere Virgili, Barcelona, Spain.
Vall d'Hebrón Institute of Research, Barcelona, Spain.

C Pedone (C)

Area di Geriatria, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy.

M Inzitari (M)

Parc Sanitari Pere Virgili, Barcelona, Spain.
Vall d'Hebrón Institute of Research, Barcelona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.

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