Suboptimal vitamin D status is a highly prevalent but treatable condition in both hospitalized patients and the general population

PURPOSE: To heighten awareness of the problems related to the high prevalence of suboptimal vitamin D status in hospitalized patients and the general population, including an overview of vitamin D biology, how vitamin D status is defined, the negative health issues associated with suboptimal vitamin D status, indications for treatment, treatment strategies, and controversies in the field. DATA SOURCES: (a) Literature review was performed using PubMed and CINAHL databases to locate and review medical, nursing, and nutritional journals. (b) Authors' recent prospective studies of 100 patients in a general tertiary hospital rehabilitation unit and 51 nonhospitalized volunteers. CONCLUSION: Poor vitamin D status (ranging from suboptimal to overt deficiency) is common in both hospitalized patients and ostensibly healthy individuals of all ages and geographic latitude. Suboptimal vitamin D status is associated with muscle weakness, functional deficits, and perhaps longer length of stay of hospitalized patients. Predictors of vitamin D status include race, poor nutrition, advanced age, use of multivitamins, ultraviolet light exposure, and grip strength. Fortunately, treatment with 50,000 IU of vitamin D(2) for several weeks is a very inexpensive and safe yet effective treatment to replete vitamin D status. IMPLICATIONS FOR PRACTICE: NPs should be aware of the indications for monitoring vitamin D status and the appropriate treatment for suboptimal vitamin D status. Improving vitamin D status may improve a patient's functional ability, therefore decreasing falls and preventing fractures, decreasing length of stay in the hospital, and decreasing the cost of health care. Providers can potentially improve the life of older adults by educating patients on the importance of vitamin D supplementation.