Vitamin D deficiency in elderly

Introduction
Vitamin D, a fat-soluble essential nutrient, is required to maintain optimum mental and physical health. It is apparent that each phase of life demands this vitamin in different proportions to experience the best of health. Vitamin D deficiency invites numerous health complications, some of which cannot be reversed even after attempting the supreme therapies. However, a few factors affect the vitamin D levels in the body, age being one of them.

The primary source of absorbing vitamin D is sunlight; however, one can even rely on supplements to fulfill the requirement quotient combined with the proper diet. It is found that aging weakens one’s potency to absorb more vitamin D, and thus, older adults often face a deficiency of vitamin D and problems associated with it.

Let’s dig into it and understand the impact of vitamin D on the health of the elderly.

Causes of Vitamin D deficiency in elderly
Vitamin D deficiency could occur at any age, depending upon an individual’s physiology. However, it is usually found that vitamin D deficiency is more in older adults than in other age groups. Also, researchers predict that even twice the amount of vitamin D might stand insufficient for ill and healthy elderly patients as vitamin D absorption becomes a little impaired at this age.
Mentioned here are a few causes of vitamin D deficiency in the elderly:

• Reduction in intake
  There are numerous foods fortified with vitamin D, such as dairy products. However, the will to consume more food decreases due to age, which could be why older people suffer a deficiency of nutrients such as vitamin D. Also, some of them even experience difficulties digesting food, and thus, they limit their food intake due to following anxiety.
• Less exposure to the sun
  People at an old age prefer spending more time at home due to the underlying health insufficiencies of the elderly in many parts of the world. Also, some places receive less sunlight. As a result, individuals, mainly elder adults residing in such areas, are at an increased risk of vitamin D deficiency.
• Increased adiposity
  An increase in adipose tissues of the body that is gaining more weight and rolling on the path of obesity could be related to vitamin D deficiency. Subjecting to hormonal change combined with the consequences of climate adversities and changing lifestyle could accumulate more fat in older people. However, the decreased bioavailability of vitamin D makes the elderly deficient in it. This rationale is that since vitamin D is a fat-soluble vitamin, and when there are more fat cells in the body, it chooses to be with them rather than circulating in the bloodstream.
• Decreased synthesis in the skin
  As human beings age, there is a decrease in 7 dehydrocholesterol (precursor of vitamin D) in the skin. Studies have found that once we cross the age of 40, there is about a 10 to 15% reduction in the level of 7 dehydrocholesterol every decade of life. This signifies that vitamin D synthesis in the skin reduces as we age.

Effects of Vitamin D deficiency in elderly
Earlier studies focused on how vitamin D levels influence skeletal health. However, in the last few years, scientists have found that vitamin D receptors are present all over the body and play an essential role in different bodily functions. This implies that vitamin D deficiency could relate to various health problems. Thus, let’s have a look at the effects of vitamin D deficiency in elder individuals:

• Osteoporosis
  Out of many factors that increase the risk of osteoporosis in older people, the primary reasons are low calcium and vitamin D levels in the body. Osteoporosis is a bone disease in which the bones become porous and weak. Also, the possibility of falls and fractures in elder individuals becomes higher due to the lack of vitamin D in the body, preventing the absorption of enough calcium in the bones.
•  Cognition defaults
  The decline in cognition is a severe phase of mental health that could range from mild cognitive impairment to the full-fledged condition of advanced stage, leading to dementia. In addition, studies have shown that low vitamin D levels in the elderly could exaggerate the cognitive decline, inviting various mental problems.
• Hypertension
  Studies have revealed a close relationship between high blood pressure and the levels of circulating vitamin D. It has been found that vitamin D levels and hypertension are inversely related to each other. Therefore, low levels of vitamin D could suggest high blood pressure. Also, some studies even demonstrated that supplementing an old vitamin D deficient patient showed a significant reduction in hypertension.
• Decreased Immunity
  As individuals age, the immune system becomes weaker over time; its ability to fight diseases diminishes. Followed by the deficiency of vitamin D could entice the worst scenario, sometimes even death. However, research has suggested that strengthening an older adult with vitamin D could regulate innate and adaptive immune responses. Also, there have been instances when Vitamin D is used as a therapeutic agent in treating diseases.

Is too much Vitamin D good for the elderly?
Well, no. High doses of vitamin D are not generally suitable for older adults. This is because it could drastically increase calcium levels in the body. Too much calcium could result in unfavorable health conditions such as mental confusion. Also, it could invite problems associated with the heart accompanied by general weakness and nausea.

Hopeful Verdict
The Elderly is a critical yet polished stage of life that caters to ample experiences to survive satisfactorily. Although sunlight is the natural and significant source of Vitamin D, being an older adult, one must acknowledge that solely relying on sunlight for absorbing vitamin D would not work well. Therefore, it is equally required to incorporate some Vitamin D supplements and a minimum of 30 minutes of exposure to the sun. In a nutshell, either through food, sunshine, or supplements, soaking in the right amount of vitamin D is essential to sustain vitality during old age.

References:

1. The best testosterone boosters for men over 50 [Internet]. WebMD. [cited 2022 Jan 23]. Available from: https://www.webmd.com/healthy-aging/the-best-testosterone-boosters-for-men-over-50
2. Lasslo-Meeks M. Obesity in older adults. J Am Diet Assoc [Internet]. 1999 [cited 2022 Jan 23];99(9):1050. Available from: https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No1Jan09/Obesity-in-Older-Adults.html
3. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr [Internet]. 2000 [cited 2022 Jan 23];72(3):690–3. Available from: https://academic.oup.com/ajcn/article/72/3/690/4729361
4. Kupisz-Urbańska M, Łukaszkiewicz J, Marcinowska-Suchowierska E. Vitamin D in Elderly. In: Özdemir Ö, editor. Vitamin D. London, England: IntechOpen; 2021. https://www.intechopen.com/chapters/76645
5. Meehan M, Penckofer S. The role of vitamin D in the aging adult. J Aging Gerontol [Internet]. 2014 [cited 2022 Jan 23];2(2):60–71. Available from: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4399494/