ALARMING VITAMIN D DEFICIENCY IN OLDER PSYCHIATRIC INPATIENTS
R.M. Marijnissen, W.J. Derks, A.B. Gaasbeek, S.C. Stalpers-Konijnenburg, R.C. Oude Voshaar
J Aging Res Clin Practice 2013;2(1):137-141
Objectives: To explore vitamin D levels in older persons admitted to a psychiatric ward, acknowledging its potential relationship with a variety of psychiatric disorders and high prevalence rates of inadequate vitamin D levels in later life. Design: Consecutive case-series. Setting: Old age psychiatry ward of a secondary mental health centre in the Netherlands. Participants: 159 patients aged 52 to 94 admitted at the old age psychiatry ward. Measurements: Serum vitamin D3 (25(OH)D) levels were determined by taking a fasting blood sample within two days of admission and classified in five categories, i.e. severe deficient (< 10 nmol/l), deficient (10-24 nmol/l), insufficient (25-49 nmol/l), hypovitaminosis (50-74) and adequate (≥75 nmol/l) serum levels. Psychiatric diagnosis was made according to DSM-IV-TR criteria and classified in five overarching categories, i.e. depressive disorders, bipolar disorder, cognitive disorder no delirium, psychotic disorders and other psychiatric disorders. Results: Only 4/159 (2.5%) patients had adequate vitamin D levels. In 35 (22.0%) patients we found hypovitaminosis, vitamin D insufficiency in 69 patients (43.4%) and deficiency in 51 patients (32.0%) of which 15 patients (9.4%) had a severe deficiency. Although the prevalence of insufficiency and deficiency did no differ across diagnostic groups, patients with psychotic disorders had lower levels of vitamin D compared to the other diagnostic groups. Conclusion: The high prevalence of inadequate vitamin D levels argues for screening of vitamin D levels in older persons admitted to a psychiatric ward enabling an optimal vitamin D supplementation. The wide range of inadequate levels supports vitamin D assessment to determine the appropriate supplementation dosage regime.