The Role of Vitamin D in the Aging Adult

Authors

  • Meghan Meehan School of Nursing, Loyola University Chicago, IL., USA
  • Sue Penckofer School of Nursing, Loyola University Chicago, IL., USA

DOI:

https://doi.org/10.12974/2309-6128.2014.02.02.1

Keywords:

Aging, older adult, vitamin D.

Abstract

The number of individuals aged 65 and older is expected to more than double from 2012 to 2060. The role of vitamin D in the prevention and treatment of diseases associated with aging has not been well studied. Traditionally, the role of vitamin D focused on the maintenance of skeletal health in the older adult. With the discovery of vitamin D receptors in the nervous, cardiovascular and endocrine systems, the role of vitamin D and its impact on these systems has become an important area of research. Older adults are at risk for lower levels of vitamin D as a result of decreased cutaneous synthesis and dietary intake of vitamin D. Epidemiologic evidence indicates an association between low levels of vitamin D and diseases associated with aging such as cognitive decline, depression, osteoporosis, cardiovascular disease, hypertension, type 2 diabetes, and cancer. Clinical trials to determine the benefit of vitamin D supplementation in preventing and treating such diseases are in progress. This paper highlights current evidence regarding the role that vitamin D may play in diseases associated with aging and addresses the need for well-designed randomized trials to examine its benefit on health outcomes in the older adult. 

References

American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adult. Recommendations abstracted from the American Geriatrics Consensus Statement on Vitamin D for prevention of falls and their consequences. J Am Geriatr Soc 2014; 62: 147-52. http://dx.doi.org/10.1111/jgs.12631

American Psychiatric Association. Depression 2012. http://www.psychiatry.org/mental-health/keytopics/ depression (accessed 3/1/2013)

Anglin RES, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry 2013; 202: 100-7. http://dx.doi.org/10.1192/bjp.bp.111.106666

Annweiler C, Beauchet O. Questioning vitamin D status of elderly fallers and non-fallers: a meta-analysis to address a ‘forgotten step’. J Intern Med 2014; April 4 (e-pub)

Annweiler C, Beauhet O. Vitamin D in older adults: the need to specify standard values with respect to cognition. Front Aging Neurosci 2014; 6(72): 1-6.

Annweiler C, Montero-Odasso M, Schott AM, Berrut G, Fantino B, Beauchet O. Fall prevention and vitamin D in the elderly: an overview of the key role of the non-bone effects. Journal of NeuroEngineering and Rehabilitation 2010; 7(50): 1-13.

Aranow C. Vitamin d and the immune system. J Investig Med 2011; 59(6): 881-886.

Avenell A, Gillespie WJ, Gillespie LD, O’Connell D. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database of Syst Rev 2009; 4 (2): 1-120.

Bertone-Johnson ER, Powers SI, Spangler L, Brunner RL, Michael YL, Larson JC, et al. Vitamin D intake from foods and supplements and depressive symptoms in a diverse population of older women. Am J Clin Nutr 2011; 94: 1104- 12. http://dx.doi.org/10.3945/ajcn.111.017384

Bischoff-Ferrari HA, Willet WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, et al. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 2012; 367: 40-9. http://dx.doi.org/10.1056/NEJMoa1109617

Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, OravEJ, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a metaanalysis of randomized controlled trials. Arch Intern Med 2009; 169(6): 551-61. http://dx.doi.org/10.1001/archinternmed.2008.600

Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, et al. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database of Syst Rev 2014; 1: 1-254.

Bolland MJ, Gray A, Gamble GD, Reid IR. Calcium and vitamin D supplements and health outcomes: a reanalysis of the Women's Health Initiative (WHI) limited-access data set. Am J Clin Nutr 2011; 94(4): 1144-9. http://dx.doi.org/10.3945/ajcn.111.015032

Boldo A, Campbell P, Luthra P, White WB. Should the concentration of vitamin D be measured in all patients with hypertension? J Clin Hypertens 2010; 12(3): 149-52. http://dx.doi.org/10.1111/j.1751-7176.2009.00246.x

Buell JS, Scott TM, Dawson-Hughes B, Dallal GE, Rosenberg IH, Folstein MF, et al. Vitamin D is associated with cognitive function in elders receiving home health services. J Gerontol A Biol Sci Med Sci 2009; 64A(8): 888- 95. http://dx.doi.org/10.1093/gerona/glp032

Bulati M, Buffa S, Candore G, Caruso C, Dunn-Walters DK, Pellicano M, et al. B cells and immunosenescence: a focus on IgGIgD CD27 (DN) B cells in aged humans. Ageing Research Reviews 2011; 10(2): 274-284. http://dx.doi.org/10.1016/j.arr.2010.12.002

Burgaz A, Orsini N, Larsson SC, Wolk A. Blood 25- hydroxyvitamin D concentration and hypertension: a metaanalysis. Journal of Hypertension 2010; 29: 636-45. http://dx.doi.org/10.1097/HJH.0b013e32834320f9

Camargo CA. Vitamin D and cardiovascular disease. JACC 2011; 58(14): 1442-4. http://dx.doi.org/10.1016/j.jacc.2011.06.037

Centers for Disease Control and Prevention. Healthy brain initiative 2011. http://www.cdc.gov/aging/healthybrain/index. htm (accessed 3/1/2013)

Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and pre-diabetes in the United States, 2011.http://www.cdc.gov/diabetes/pubs/pdf/ndfs_ 2011.pdf(accessed 3/1/2013)

Cesari M, Incalzi RA, Zamboni V, Pahor M. Vitamin D hormone: a multitude of actions potentially influencing the physical function decline in the older persons. Geriatr Gerontol Int 2011; 11: 133-42. http://dx.doi.org/10.1111/j.1447-0594.2010.00668.x

Chan R, Woo J. The value of vitamin D supplementation in older people. Nutritional Therapy & Metabolism 2011; 29(1): 8-21.

Chowdhury R, Kunutsor S, Vitezova A, Oliver-Williams C, Chowdhury S, Kiefte-de-Jong JC, et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomized intervention studies. BMJ 2014; 348: 1-13. http://dx.doi.org/10.1136/bmj.g1903

Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J, et al. Vitamin D and calcium: systematic review of health outcomes. Evidence report No 183. Agency for Healthcare Research and Quality, 2009.

Davidson MB, Duran P, Lee ML, Friedman TC. High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D. Diabetes Care 2013; 36(2): 260-6. http://dx.doi.org/10.2337/dc12-1204

Dawson-Hughes B, Harris SS. High-dose vitamin D supplementation too much of a good thing? JAMA 2010; 303(18): 1861-2. http://dx.doi.org/10.1001/jama.2010.598

Dickens AP, Lang IA, Langa KM, Kos K, Llewellyn DJ. Vitamin D, cognitive dysfunction and dementia in older adults. CNS Drugs 2011; 25(8): 629-39. http://dx.doi.org/10.2165/11593080-000000000-00000

DIPART (Vitamin D Individual Patient Analysis of Randomized Trials) Group. Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in US and Europe. BMJ 2010; 340: b5463-b71. http://dx.doi.org/10.1136/bmj.b5463

Elamin MB, Elnour NOA, Elamin KB, Fatourechi MM, Alkatib AA, Almandoz JP, et al. Vitamin D and cardiovascular outcomes: a systematic review and meta-analysis. J Clin Endocrinol Metab 2011; 96(7): 1931-42. http://dx.doi.org/10.1210/jc.2011-0398

Florez H, Troen BR. Do vitamin D levels influence the risk of diabetes mellitus and play a role in healthier aging? JAGS 2011; 59: 1957-9. http://dx.doi.org/10.1111/j.1532-5415.2011.03592.x

George PS, Pearson ER, Witham MD. Effect of vitamin D supplementation on glycemic control and insulin resistance: a systematic review and meta-analysis. Diabetic Medicine 2012; 29: 142-150. http://dx.doi.org/10.1111/j.1464-5491.2012.03672.x

Gulseth HL, Wium C, Birkeland KI. Vitamin D and insulin action and secretion: an overview of current understanding and future perspectives. European Endocrinology 2010; 6(2): 13-8.

Hirani V. Relationships between vitamin D and hyperglycemia in older people from a nationally representative population survey. JAGS 2011; 59: 1786-92. http://dx.doi.org/10.1111/j.1532-5415.2011.03590.x

Hoang MT, DeFina LF, Willis BL, Leonard DS, Weiner MF, Brown ES. Association between low serum 25- hydroxyvitamin D and depression in a large sample of healthy adults: The Cooper Center longitudinal study. Mayo Clin Proc 2011; 86(11): 1050-5. http://dx.doi.org/10.4065/mcp.2011.0208

Holick MF. The vitamin D deficiency pandemic: a forgotten hormone important for health. Public Health Reviews 2010; 32: 267-83.

Holick MF. Vitamin D: a delightful solution for health. J Investig Med 2011; 59(6): 872-80.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011; 96(7): 1911-30. http://dx.doi.org/10.1210/jc.2011-0385

Hoogendijk WJG, Lips P, Dik MG, Deeg DJH, Beekman ATF, Penninx BWJH. Depression is associated with decreased 25- hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry 2008; 65: 508-12. http://dx.doi.org/10.1001/archpsyc.65.5.508

Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc 2013; 88(7): 720-55. http://dx.doi.org/10.1016/j.mayocp.2013.05.011

Institute of Medicine. Dietary reference intakes for calcium and vitamin D: report brief 2010. http://www.iom.edu/Reports/ 2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin- D.aspx (accessed 3/1/2013)

Kestendaum B, Katz R, De Boer I, Hoofnagle A, Sarnak MJ, Shlipak MG, et al. Vitamin D, parathyroid hormone, and cardiovascular events among older adults. JACC 2011; 58(14): 1433-41. http://dx.doi.org/10.1016/j.jacc.2011.03.069

Khan H, Kunutsor S, Franco OH, Chowdhury R. Vitamin D, type 2 diabetes and other metabolic outcomes: a systematic review and meta-analysis of prospective studies. Proc Nutr Soc 2013; 72(1): 89-97. http://dx.doi.org/10.1017/S0029665112002765

Kjaergaard M, Waterloo K, Wang CEA, Almas B, Figenschau Y, Hutchinson MS, et al. Effect of vitamin D supplement on depression scores in people with low levels of serum 25- hydroxyvitamin D: nested case-control study and randomized clinical trial. BJP 2012; 201(5): 360-8. http://dx.doi.org/10.1192/bjp.bp.111.104349

Lapid MI, Cha SS, Takahashi PY. Vitamin D and depression in geriatric primary care patients. Clin Interv Aging 2013; 8: 509-14. http://dx.doi.org/10.2147/CIA.S42838

Lee JE, Li H, Chan AT, Hollis BW, Lee IM, Stampfer MJ, et al. Circulating levels of vitamin d and colon and rectal cancer: the Physicians' Health Study and a meta-analysis of prospective studies. Cancer Prev Rev 2011; 4(5): 735-43. http://dx.doi.org/10.1158/1940-6207.CAPR-10-0289

Lee DM, Tajar A, Ulubaev A, Pendelton N, O’Neill TM, O’Connor DB, et al. Association between 25-hydroxyvitamin D levels and cognitive performance in middle-aged and older European men. J Neurol Neurosurg Psychiatry 2009; 80: 722-9. http://dx.doi.org/10.1136/jnnp.2008.165720

Littlejohns TJ, Henley WE, Lang IA, Annweiler C, Beauchet O, Chaves PHM, et al. Vitamin d and the risk of dementia and Alzheimer disease. Neurology 2014; 83: 1-9.

Llewellyn DJ, Lang IA, Langa KA, Melzer D. Vitamin D and cognitive impairment in the elderly U.S. population. Gerontol A Biol Sci Med Sci 2011; 66(1): 59-65.

Llewellyn DJ, Lang IA, Langa KM, Muniz-Terrera G, Phillips CL, Cherubini A, et al. Vitamin D and risk of cognitive decline in elderly persons. Arch Intern Med 2010; 170(13): 1135-41. http://dx.doi.org/10.1001/archinternmed.2010.173

Llewellyn DJ, Langa KM, Lang IA. Serum 25-hydroxyvitamin D concentration and cognitive impairment. J Geriatr Psychiatry Neurol 2009; 22(3): 188-95. http://dx.doi.org/10.1177/0891988708327888

Mitri J, Dawson-Hughes B, Hu FB, Pittas AG. Effects of vitamin D and calcium supplementation on pancreatic beta cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the calcium and vitamin D for diabetes mellitus (CaDDM) randomized controlled trial. The American Journal of Clinical Nutrition 2011; 94(2): 486-94. http://dx.doi.org/10.3945/ajcn.111.011684

Moyer VA on behalf of the US Preventative Task Force. Prevention of falls in community-dwelling older adults: US preventative task force recommendation statement. Ann Intern Med 2012; 157(3): 197-204. http://dx.doi.org/10.7326/0003-4819-157-3-201208070- 00462

National Osteoporosis Foundation. Fast facts 2010. http://www.nof.org/learn (accessed 3/1/2013)

Newberry SJ, Chung M, Shekelle PG, Booth MS, Liu JL, Maher AR, et al. Vitamin d and calcium: a systematic review of health outcomes (update). Evidence Report/Technology Assessment No. 217. (Prepared by the Southern California Evidence-based Practice Center under Contract No. 290- 012-00006-I.)AHRQ Publication No. 4-E004-EF.Rockville, MD: Agency for Healthcare Research and Quality. September 2014. www.effectivehealthcare.ahrq.gov/reports/ final.cfm

Office of Dietary Supplements, National Institute of Health. Vitamin d fact sheet for health professionals 2011. http://ods.od.nih.gov/factsheets/VitaminDHealthProfessional/( accessed 9/1/2014)

Pilz S, Tomaschitz A, Ritz E, Pieber TR. Vitamin D status and arterial hypertension: a systematic review. Nat Rev Cardiol 2009; 6(10): 621-30. http://dx.doi.org/10.1038/nrcardio.2009.135

Rossom RC, Espeland ME, Manson JE, Dysken MW, Johnson KC, Lane DS, et al. Calcium and vitamin D supplementation and cognitive impairment in the Women’s Health Initiative. JAGS 2012; 60(12): 2197-2205.

Sanders KA, Stuart AL, Williamson EJ, Jacka FN, Dodd S, Nicholson G, et al. Annual high-dose vitamin D3 and mental well-being: randomised controlled trial. BJPsych 2011; 198: 357-64.

Sanders KA, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, et al. Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 2010; 303(18): 1815-22. http://dx.doi.org/10.1001/jama.2010.594

Schlogl M, Holick MF. Vitamin D and neurocognitive function. Clin Interv Aging 2014; 9: 559-68.

Shui IM, Mucci LA, Tamimi RM, Lindstrom S, Penney KL, Nimptsch K, et al. Vitamin D-related genetic variation, plasma vitamin D, and risk of lethal prostate cancer: a prospective nested case-control study. J Natl Cancer Inst 2012; 104(9): 690-9. http://dx.doi.org/10.1093/jnci/djs189

Slinin Y, Paudel ML, Taylor BC, Fink HA, Ishani A, Canales MT, et al. 25-Hydroxyvitamin D levels and cognitive performance and decline in elderly men. Neurology 2010; 74: 33-41. http://dx.doi.org/10.1212/WNL.0b013e3181c7197b

Sperati F, Vici P, Maugeri-Sacca M, Stranges S, Santesso N, Luciano M, et al. Vitamin d supplementation and breast cancer prevention: a systematic review and meta-analysis of randomized clinical trials. PLoS One 2013; 8(7): e69269. http://dx.doi.org/10.1371/journal.pone.0069269

Stewart R, Hirani V. Relationship between vitamin D levels and depressive symptoms in older residents from a national survey population. Psychosomatic Medicine 2010; 72: 608- 12. http://dx.doi.org/10.1097/PSY.0b013e3181e9bf15

Sun Q, Pan A, Hu FB, Manson JE, Rexrode KM. 25- Hydroxyvitamin D levels and the risks of stroke: a prospective study and meta-analysis. Stroke 2012; 43: 1470- 7. http://dx.doi.org/10.1161/STROKEAHA.111.636910

Tamez H, Thadhani RI. Vitamin D and hypertension: an update and review. Curr Opin Nephrol Hypertens 2012; 21(5): 492-9. http://dx.doi.org/10.1097/MNH.0b013e3283557bf0

U.S. Census. US Census Bureau projections show a slower growing, older, more diverse nation a half century from now 2012. http://census.gov/newsroom/releases/archives/ population/cb12-243.html (accessed 5/21/2014)

Vaidya A, Forman JP. Vitamin D and hypertension: current evidence and future direction. Hypertension 2010; 56: 774-9. http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.140160

van den Bergh JP, Bours SP, van Geel TA, Geusens PP. Optimal use of vitamin D when treating osteoporosis. Curr Osteoporosis Rep 2011; 9: 36-42.

Wallis D, Penckofer S, Sizemore G. Contemporary issues in cardiovascular medicine: the sunshine deficit and cardiovascular disease. Circulation 2008; 118: 1476-85.

Wang L, Manson JE, Song Y, Sesso HD. Systematic review: vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med 2010; 152: 315-23. http://dx.doi.org/10.7326/0003-4819-152-5-201003020- 00010

Wilson VK, Houston DK, Kilpatrick L, Lovato J, Yaffe K, Cauley JA, et al. Relationship between 25-hydroxyvitamin D and cognitive function in older adults: the health, aging and body composition study. JAGS 2014; 62: 636-41. http://dx.doi.org/10.1111/jgs.12765

Witham MD, Price RJG, Struthers AD, Donnan PT, Messo CM, Ford I, et al. Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial. JAMA Intern Med 2013; 173(18): 1672-79.

World Health Organization. New data highlight increases in hypertension, diabetes incidence 2012. http://www.who.int/ mediacentre/news/releases/2012/world_health_statistics_20 120516/en/index.html (accessed 3/1/2013)

World Health Organization. The atlas of heart disease and stroke. http://www.who.int/cardiovascular_diseases/ resources/atlas/en/ (accessed 6/22/2014)

Downloads

Published

2014-07-25

How to Cite

Meehan, M., & Penckofer, S. (2014). The Role of Vitamin D in the Aging Adult. Journal of Aging and Gerontology, 2(2), 60–71. https://doi.org/10.12974/2309-6128.2014.02.02.1

Issue

Section

Articles