| Title: | Low Vitamin D Levels and Risk of Incident Delirium in 351,000 Older UK Biobank Participants |
| Journal: | Journal of the American Geriatrics Society |
| Published: | 5 Oct 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/33017050/ |
| DOI: | https://doi.org/10.1111/jgs.16853 |
| URL: | https://agsjournals.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jgs.16853 |
| Citations: | 26 (15 in last 2 years) as of 8 Aug 2024 |
Publication 5345
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Abstract
BACKGROUND/OBJECTIVES: Delirium is common in older adults, especially following hospitalization. Because low vitamin D levels may be associated with increased delirium risk, we aimed to determine the prognostic value of blood vitamin D levels, extending our previous genetic analyses of this relationship.</p>
DESIGN: Prospective cohort analysis.</p>
SETTING: Community-based cohort study of adults from 22 cities across the United Kingdom (the UK Biobank).</p>
PARTICIPANTS: Adults aged 60 and older by the end of follow-up in the linked hospital inpatient admissions data, up to 14 years after baseline (n = 351,320).</p>
MEASUREMENTS: At baseline, serum vitamin D (25-OH-D) levels were measured. We used time-to-event models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between vitamin D deficiency and incident hospital-diagnosed delirium, adjusted for age, sex, assessment month, assessment center, and ethnicity. We performed Mendelian randomization genetic analysis in European participants to further investigate vitamin D and delirium risk.</p>
RESULTS: A total of 3,634 (1.03%) participants had at least one incident hospital-diagnosed delirium episode. Vitamin D deficiency (<25 nmol/L) predicted a large incidence in delirium (HR = 2.49; 95% CI = 2.24-2.76; P = 3*10-68 , compared with >50 nmol/L). Increased risk was not limited to the deficient group: insufficient levels (25-50 nmol/L) were also at increased risk (HR = 1.38; 95% CI = 1.28-1.49; P = 4*10-18 ). The association was independent of calcium levels, hospital-diagnosed fractures, dementia, and other relevant cofactors. In genetic analysis, participants carrying more vitamin D-increasing variants had a reduced likelihood of incident delirium diagnosis (HR = .80 per standard deviation increase in genetically instrumented vitamin D: .73-.87; P = 2*10-7 ).</p>
CONCLUSION: Progressively lower vitamin D levels predicted increased risks of incident hospital-diagnosed delirium, and genetic evidence supports a shared causal pathway. Because low vitamin D levels are simple to detect and inexpensive and safe to correct, an intervention trial to confirm these results is urgently needed.</p>
18 Keywords
- Aged
- Biological Specimen Banks
- Causality
- Cohort Studies
- Delirium
- Female
- Geriatric Assessment
- Hospitalization
- Humans
- Incidence
- Male
- Mendelian Randomization Analysis
- Predictive Value of Tests
- Risk Assessment
- Risk Factors
- United Kingdom
- Vitamin D
- Vitamin D Deficiency
9 Authors
- Luke C. Pilling
- Lindsay C. Jones
- Jane A. H. Masoli
- João Delgado
- Janice L. Atkins
- Jack Bowden
- Richard H. Fortinsky
- George A. Kuchel
- David Melzer
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