Premium
Falls Relate to Vitamin D and Parathyroid Hormone in an Australian Nursing Home and Hostel
Author(s) -
Stein Mark S.,
Wark John D.,
Scherer Samuel C.,
Walton S. Lynette,
Chick Patricia,
Carlantonio Margaret,
Zajac Jeffrey D.,
Flicker Leon
Publication year - 1999
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1999.tb05199.x
Subject(s) - medicine , interquartile range , parathyroid hormone , vitamin d and neurology , odds ratio , endocrinology , calcium
OBJECTIVES: To determine whether falling relates to serum levels of vitamin D and parathyroid hormone. DESIGN: A cross‐sectional study with retrospective analysis. SETTING: An aged‐care institution in Melbourne Australia. PARTICIPANTS: Ambulant nursing home and hostel residents (n = 83). MEASUREMENTS: Frequency of falling, frequency of going outdoors, use of cane or walker, age, sex, weight, type of accommodation, and duration of residence. Serum concentrations of 25‐hydroxyvitamin D, 1,25‐dihydroxyvitamin D, and parathyroid hormone (PTH). Plasma concentrations of albumin, calcium, phosphate, and creatinine. Use of furo‐semide or non‐benzodiazepine anticonvulsants. RESULTS: Median age of residents was 84 years. The cohort was vitamin D deficient with a median (interquartile range) 25‐hydroxyvitamin D level of 27 (18–37) nmol/L (one‐third the reference range median), P < .001. The median (interquartile range) PTH of 5.2 (3.8‐7.7) pmol/L exceeded the reference range median, P < .001. Residents who fell (n = 33) had lower serum 25‐hydroxyvitamin D levels than other residents (medians 22 vs 29 nmol/L, P = .02) and higher serum PTH levels (medians 6.2 vs 4.8 pmol/L, P < .01). Sixty residents lived in the hostel (72%), and 41 (49%) walked without any walking aid. In a multiple logistic regression for falling, higher serum PTH remained independently associated with falling, with an odds ratio (95% confidence interval) for falling of 5.6 (1.7–18.5) per unit of the natural logarithm of serum PTH. Other terms in the regression were hostel accommodation, odds ratio .04 (.01‐.25), and ability to walk without aids, odds ratio .07 (.01‐.37). CONCLUSIONS: In ambulant nursing home and hostel residents, residents who fall have lower serum 25‐hydroxyvitamin D and higher serum parathyroid hormone levels than other residents. The association between falling and serum PTH persists after adjustment for other variables.