“In view of our findings and the existing literature of adverse effects of vitamin D deficiency, there exists now an urgent need for effective strategies to improve vitamin D status in older institutionalized patients.”
These are not my words, but I would add a more urgent need exists for non-institutionalized people, especially young people.
The quote above are the words of Dr. Sefan Pitz and nine colleagues from Austria and Germany who studied 95 nursing homes in Austria, obtaining vitamin D levels on 961 participants. Their average age was 83 and their average vitamin D level was a remarkable 7 ng/ml, although 7% had levels above 20 ng/ml. They drew the blood in 2002, so the authors could go back through the charts and see who later died and compare that to their 2002 vitamin D levels.
Pilz S, Dobnig H, Tomaschitz A, Kienreich K, Meinitzer A, Friedl C, Wagner D, Piswanger-Sölkner C, März W, Fahrleitner-Pammer A. Low 25-Hydroxyvitamin D Is Associated with Increased Mortality in Female Nursing Home Residents. J Clin Endocrinol Metab. 2012 Feb 8.
Thirty percent of the residents died in just 24 months, and yes, the lower the vitamin D, the more likely they were to die (almost double). However, this brings up a question that has bothered me for a long time. How can so many people continue to live with a vitamin D level of 7 ng/ml? The authors refer to an Italian study in which many of the nursing home residents had undetectable vitamin D levels, and yet many of these same residents with undetectable levels were greater than 100 years old.
Perhaps the vitamin D levels plummeted with their admission to nursing homes? Perhaps, before admission, they were tending their flower gardens and sitting in the sun (the sun scare is a modern phenomenon). In fact one of my favorite quotes is the Italian one that goes, “Where the sun does not go the doctor does.”
However, it would be dishonest for us not to admit that some people live to be a hundred with incredibly low vitamin D levels. But I do think research is showing and will show that the incidence of many of these sad, before-their-time deaths you read in the obituary section can be decreased with higher vitamin D levels over an entire population.
That’s why I find myself objecting to the authors repeated call for supplementation only in nursing homes. While clearly needed, I can’t help but compare the tragedies of a 35 year-old mother of three, dead with breast cancer to the death of a 100-year-old nursing home resident. I am 63 and as I age, I keep thinking of what that governor of Colorado once said (now ex-governor). He said that we all have a responsibility to die when our time comes. When my time comes, will I have the courage of my convictions or will I cling to a decrepit life like a drowning man?