Funded in part by International Vitamin D Expert Association
Vitamin D in the older population: a consensus statement
Giustina A, Bouillon R, Dawson-Hughes B, Ebeling PR, Lazaretti-Castro M, Lips P, Marcocci C, Bilezikian JP
Endocrine · 153 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Expert or government fact sheet (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Industry funded
- Industry group
- International Vitamin D Expert Association
Based on 1 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2022-10-26 · Endocrine · vol. 79 · issue 1 · pp. 31–44
- Publisher
- Springer Science+Business Media
- Cited
- 206 citations · more than 100% of similar papers · 22.4× the field average
- Impact
- Top 10% most cited in its field
- References
- 98 works
- Access
- Open access (hybrid journal) · CC-BY
- Research areas
- Vitamin D Research Studies · HIV-related health complications and treatments · Vitamin C and Antioxidants Research
- Keywords
- Vitamin D and neurology, vitamin D deficiency, Medicine, Population, Hypovitaminosis, Gerontology, Diabetes mellitus, Environmental health, Endocrinology
- MeSH
- humans, vitamin d deficiency, vitamins, vitamin d, dietary supplements, aged, fractures, bone, covid-19, covid-19 vaccines
8 authors
From IT, BE, US, AU, BR, NL
- Andrea GiustinaVita-Salute San Raffaele University
- Roger BouillonKU Leuven
- Bess Dawson‐HughesTufts University; Jean Mayer Human Nutrition Research Center on Aging
- Peter Robert EbelingMonash University
- Marise Lazaretti‐CastroUniversidade Federal de São Paulo
- Paul T.A.M. LipsAmsterdam University Medical Centers
Abstract
Background
This paper reports results from the 5th International Conference "Controversies in Vitamin D" that was held in Stresa, Italy, 15-18 September 2021. The conference is part of this series that started in 2017 and has been conducted annually since. The objective of these conferences is to identify timely and controversial topics related to Vitamin D. Dissemination of the results of the conference through publications in peer-reviewed journals is an important means by which the most up to date information can be shared with physicians, investigators, and other health care professionals. Vitamin D and aging, the subject of this paper was featured at the conference.
Methods
Participants were selected to review available literature on assigned topics related to vitamin D and aging and to present their findings with illustrative material, the intent of which was to stimulate discussion and to arrive at a consensus. The presentations were directed towards the following areas: impact of aging on vitamin D production and levels; skeletal effects of vitamin D deficiency in the older population; falls and vitamin D in the aging; potential extra skeletal effects of vitamin D; and strategies to prevent vitamin D deficiency. A final topic was related to how vitamin D might influence the efficacy of vaccines for Covid-19.
Results
Hypovitaminosis D can lead to several skeletal and extra-skeletal outcomes. Older adults are at risk for vitamin D deficiency as both production and metabolism of vitamin D change with aging due to factors, such as reduced sun exposure and reduced production capacity of the skin. Skeletal consequences of these age-related changes can include reduced bone mineral density, osteomalacia and fractures. Potential extra-skeletal effects can include added risks for falls, reduced muscle strength, diabetes, cancer, and cardiovascular disease. Strategies to avoid these vitamin D deficiency-related negative outcomes include sun exposure, food fortification, and supplementation. While aging does not diminish sufficient reserve capacity for cutaneous vitamin D production, concerns about skin cancers and practical matters for the institutionalized elderly limit this option. Supplementation with vitamin D is the best option either pharmacologically or through food fortification. Regardless of treatment strategies, interventions to restore sufficient vitamin D status will show positive results only in those who are truly deficient. Thus, treatment goals should focus on avoiding 25(OH)D serum levels 50 nmol/l.
Conclusions
The results of this conference has led to consensus on several issues. Vitamin D supplementation should be combined with calcium to reduce fractures in the older population. The goal for adequate Vitamin D status should be to reach a serum level of 25(OH)D >50 nmol/l. It appears that daily low-dose vitamin D regimens reduce the risk of falling, especially in the elderly, compared with infrequent, large bolus doses that may increase it. The role of Vitamin D supplementation on muscle strength remains to be clarified. On the other hand, supplementation decreases the risk of progression to T2D from prediabetes among those who are Vitamin Ddeficient. Of three possible strategies to establish vitamin D sufficiency - sunshine exposure, food fortification, and supplementation - the latter seems to be the most effective and practical in the aging population.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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