Summary of this article
Vitamin D deficiency is highly prevalent among Indian elderly.
Symptoms include weakness, fatigue, frequent falls, and bone pain.
Prevention involves sunlight, fortified foods, supplements, and routine tests.
Vitamin D is necessary for bone health throughout life. It stops osteomalacia (softening of bones), reduces muscle weakness, and lessens the risk of falls and fractures. The body produces most vitamin D in the skin through sunlight, but a small quantity is obtained from diet.
These natural processes slow down as people age. Skin produces less vitamin D, mobility is reduced, and living in residential care restricts outdoor activities. Seniors also experience decreased appetite or dietary limitations, and in most instances, economic conditions make it more difficult to have a balanced diet.
These conditions make vitamin D deficiency more prevalent and severe in the elderly. Deficiency has also been associated with conditions other than bone health, such as infections like sepsis, cardiovascular and metabolic disorders, and certain cancers.
How Prevalent is the Issue in India
Research has shown that vitamin D deficiency is highly prevalent among older citizens.
A 2011 community-based study in Delhi by Marwaha and colleagues, titled Vitamin D Status in Healthy Indians Aged 50 Years and Above (2011), examined 1,346 healthy individuals aged 50 years and above. It found that 91.2 per cent were deficient, 6.8 per cent had insufficiency, and only 1.8 per cent had sufficient levels.
A hospital-based study from Lucknow in 2018 by Bhat and others, titled Prevalence of Vitamin D Deficiency among Geriatric Patients (2018), investigated 200 geriatric patients. It said 86.5 per cent had low vitamin D, 56 per cent were deficient and 30.5 per cent were insufficient. Just 13.5 per cent were normal.
The SANSCOG study of 2021 in rural Karnataka compared 1,648 adults aged 45 years and older. It reported that 75.7 per cent had low levels of vitamin D and 39.1 per cent were deficient. In women aged 75 years and older, 94.3 per cent had low levels.
A Hyderabad community-based study titled Prevalence of Vitamin D Deficiency among the Urban Elderly Population in Hyderabad, by Singla and others, in people aged 60 years or more, found that 56.3 per cent had deficiency. It also identified a greater risk in obese, hypertensive, and metabolic syndrome individuals.
Warning Signs
Vitamin D deficiency develops gradually and its symptoms can be harder to distinguish from usual ageing. Its frequent symptoms are chronic fatigue, weakness, cramps, and bone or back ache. Older people may also have difficulty getting up from a chair, recover slowly from minor injuries, or experience frequent stumbles and falls.
Multiple studies on elderly patients with hip fractures have reported extremely high percentages of vitamin D deficiency in them, showing how such low levels help to cause severe injuries.
Apart from Bones
The actions of vitamin D are not confined to bone. The SANSCOG study indicates correlations with cardiovascular fitness, metabolic stability, and the immune response. Older adults with low vitamin D status are at higher risk for infections, and prolonged deficiency is linked to some cancers. Because many seniors already have chronic disease, deficiency is another risk factor to contend with.
How Deficiency can be Established
Vitamin D levels can be measured by a blood test of 25-hydroxy vitamin D. In suspected cases, physicians can also examine calcium and associated markers. Seniors with recurrent falls, fractures, or extensive outdoor avoidance should get this test done.
Steps to Have Better Vitamin D Levels
Short, frequent exposures to safe sunlight is one of the best preventive measures. Standing outside, early in the day, with forearms and legs exposed for a few minutes several times a week will improve vitamin D levels. Exposure in mid-morning or mid-day is better than late afternoon.
Food sources are restricted, including fatty fish, egg yolks, and mushrooms. In India, vitamin D has been added to milk and edible oil through fortification programmes and is now available as a household commodity.
If sunlight and diet are insufficient, supplements are used. Indian Council of Medical Research–National Institute of Nutrition (ICMR–NIN) 2020 guidelines suggest approximately 600 IU of vitamin D daily and 1,000 mg of calcium in adults.
India's elderly population is expected to reach almost one fifth of the overall population by 2050. Treatment of vitamin D deficiency among them is thus a priority health need. Greater knowledge of alerting symptoms, routine check-ups, and ready availability of fortified foods can reduce hazards. While observing World Senior Citizens' Day, emphasis on vitamin D serves to remind families and communities that guarding older persons from deficiency can keep them safe, healthy, and independent.
