Status de vitamina D e fatores associados em idosos institucionalizados do Natal/RN

Abstract

Among the health problems of the elderly individual, the micronutrient deficiency that is related to various types of diseases. In this context, hypovitaminosis D has been a frequent finding among the elderly individual, especially in those institutionalized. The objective of the present study was to evaluate the vitamin D status and associated factors in elderly living in nursing homes (NH) in Natal/RN. A cross-sectional study was carried out with 153 elderly individuals living in nine Nursing Homes (NH) of the city of Natal-RN, Brazil between 2012 and 2015. The theoretical model was constructed according to the Social Determinants of Health (SDH), being chosen as dependent variable the 25 hydroxyvitamin D [25 (OH)D] level and as independent variables: type of NH, institutionalization time and schooling (distal layers); age, sex, skin color, body mass index, calf and abdominal circumference, physical activity, mobility, dietary intake of vitamin D and calcium, use of vitamin D supplementation, use of antiepileptics (proximal layers); and season (transverse layer). The concentration of 25 (OH) D in serum was determined by chemiluminescence. The elderly diagnosed with "insufficient" status when they presented values less than or equal to 29 ng/mL. Food consumption data were obtained by direct weighing of food method. Pearson's Chi-square test was used to ascertain the associations between variables. The mean age of the participants was 81.7 (9.2) years, with a predominance of females (78.4%). The majority of the elderly lived in NH (68%) and 54.7% of the elderly individuals were white. A high dietary inadequacy of vitamin D (95.4%) and calcium (79.7%) was observed, and 71.2% of the population presented hypovitaminosis D (23.9 ng / mL; CI: 22.81 - 26.13 ). Among other characteristics, 70.2% did not practice physical activity, 86.9% had some degree of mobility and 66.7% had severe cognitive impairment. Concentrations of 25 (OH) D were not significantly associated with SDH. The health care of the elderly should focus on modifiable risk factors and intervention with vitamin D, considering the aging process.