Low 25-hydroxyvitamin D is associated with increased mortality in female nursing home residents

J Clin Endocrinol Metab. 2012 Apr;97(4):E653-7. doi: 10.1210/jc.2011-3043. Epub 2012 Feb 8.


Context: Vitamin D deficiency contributes to skeletal diseases and is highly prevalent among institutionalized elderly patients. Whether low 25-hydroxyvitamin D (25[OH]D) concentrations are an independent risk factor for mortality in these patients is, however, unclear.

Objective: We aimed to evaluate whether 25(OH)D concentrations are associated with mortality.

Design, setting, and participants: This is a prospective cohort study among elderly female patients (age >70 yr) recruited from 95 nursing homes in Austria.

Main outcome measures: We calculated Cox proportional hazard ratios (HR) for all-cause mortality according to 25(OH)D quartiles.

Results: We examined 961 study participants (age 83.7 ± 6.1 yr). Median 25(OH)D concentration was 17.5 (interquartile range 13.7-25.5) nmol/liter, and 93% of our cohort had 25(OH)D levels below 50 nmol/liter. During a mean follow-up time of 27 ± 8 months, 284 patients died. Compared with the fourth quartile (25[OH]D >25.5 nmol/liter), the age-adjusted HR (with 95% confidence interval) was 1.49 (1.07-2.10) in the first 25(OH)D quartile (25[OH]D <14.0 nmol/liter), and this association remained significant after multivariate adjustments (HR = 1.56; 95% confidence interval = 1.01-2.40).

Conclusions: This Austrian study suggests that the majority of institutionalized female patients are vitamin D deficient during winter and that there was an inverse association of 25(OH)D and mortality. These data underscore the urgent need for effective strategies for the prevention and treatment of vitamin D deficiency, in particular in the setting of nursing homes.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 25-Hydroxyvitamin D 2 / blood*
  • Aged
  • Aged, 80 and over
  • Aging*
  • Austria / epidemiology
  • Calcifediol / blood*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Frail Elderly
  • Homes for the Aged
  • Humans
  • Mortality*
  • Multivariate Analysis
  • Nursing Homes
  • Prevalence
  • Proportional Hazards Models
  • Prospective Studies
  • Seasons
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / epidemiology


  • 25-Hydroxyvitamin D 2
  • Calcifediol