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

M. Visser, D.J.H. Deeg, M.T.E. Puts, J.C. Seidell, P.T.A.M. Lips

Research output: Contribution to JournalArticleAcademicpeer-review


BACKGROUND: The prevalence of vitamin D deficiency in nursing home patients is high.

OBJECTIVE: We aimed to ascertain whether lower serum 25-hydroxyvitamin 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 > or =65 y who were participating in the Longitudinal Aging Study Amsterdam (1995-1996). Study outcomes were time to nursing home admission during 6 y of follow-up and time to death until 1 April 2003.

RESULTS: Vitamin D deficiency [25(OH)D < 25 nmol/L] and insufficiency [25(OH)D = 25-49.9 nmol/L] were present in 127 (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 with 25(OH)D deficiency was 53 cases per 1000 person-years higher than that for those with high 25(OH)D (> or =75 nmol/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 vitamin D-insufficient, and 1.92 (0.79, 4.66) for vitamin D-borderline persons as compared with persons with high 25(OH)D (P for trend = 0.002). The results remained after additional adjustment for 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.

Original languageEnglish
Pages (from-to)616-22
JournalThe American Journal of Clinical Nutrition
Issue number3
Publication statusPublished - Sept 2006


  • Aged
  • Aged, 80 and over
  • Female
  • Geriatric Assessment
  • Homes for the Aged
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Netherlands
  • Nursing Homes
  • Nutritional Status
  • Patient Admission
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Sex Factors
  • Survival Rate
  • Vitamin D
  • Vitamin D Deficiency
  • Journal Article
  • Research Support, Non-U.S. Gov't


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