Association between vitamin D and pressure ulcers in older ambulatory adults: Results of a matched case-control study

Usha R. Kalava, Stephen S. Cha, Paul Y. Takahashi

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: Pressure ulcers are common among older adults, but knowledge about nutritional risk factors is still developing. Vitamin D deficiency is common in the elderly population and is required for normal skin proliferation. The role of vitamin D in pressure ulceration and wound healing is not known. The purpose of this case-control study was to determine the association between vitamin D levels and pressure ulceration in an older community-dwelling cohort. Methods: All cases and controls were community-dwelling elderly older than 60 years in a primary care panel in Olmsted County, MN. Pressure ulcer cases were defined clinically. The controls were age-matched and gender-matched to controls without pressure ulceration. The main exposure variable was 25-hydroxyvitamin D levels in both groups. The other exposure variable was the Charlson Comorbidity Index used to measure medical comorbidity. The analysis included univariate and conditional logistic regression for 25-hydroxyvitamin D levels. Results: The average (standard deviation) age of the study participants with a pressure ulcer was 80.46 years (±8.67), and the average vitamin D level was 30.92 ng/mL (±12.46). In univariate analysis, Vitamin D deficiency (levels, 25 ng/mL) was associated with pressure ulcers (odds ratio: 1.871, P = 0.0154). Comorbidities of the subjects calculated using the Charlson Comorbidity Index were also associated with pressure ulcers (odds ratio: 1.136, P, 0.001). In the final conditional logistical regression model, the association of Vitamin D and pressure ulcers became nonsignificant after adjustment for comorbid illness. Conclusion: Medical comorbidities increased the risk of pressure ulceration. Vitamin D deficiency was not an independent risk factor for pressure ulceration, and may be a marker of comorbid illness.

Original languageEnglish (US)
Pages (from-to)213-219
Number of pages7
JournalClinical interventions in aging
Volume6
Issue number1
StatePublished - 2011

Keywords

  • Aging
  • Case-control study
  • Geriatrics
  • Pressure ulcer
  • Vitamin D

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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