Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Quality of Life Research
Published in: Quality of Life Research 3/2016

Open Access 01-03-2016 | Original Paper

The effectiveness of a preventive health program and vitamin D status in improving health-related quality of life of older Canadians

Authors: J. P. Ekwaru, A. Ohinmaa, Paul J. Veugelers

Published in: Quality of Life Research | Issue 3/2016

Login to get access

Abstract

Purpose

To assess the effectiveness of a preventive health program and vitamin D status in improving the health-related quality of life (HRQOL) of older residents of Canada.

Design

We analyzed baseline and follow-up data of 2119 volunteers of a community program that promotes healthy lifestyles and encourages vitamin D supplementation. We examined the program effect on each of the five dimensions of the EQ-5D-5L, HRQOL score, and quality-adjusted life years (QALYs) using multivariable regression methods. We further examined the specific contribution of vitamin D status as quantified by serum 25-hydroxyvitamin D (25(OH)D).

Results

Problems with mobility, usual activities, pain/discomfort, and depression/anxiety were reported less during follow-up compared to baseline. On average, participants’ HRQOL had improved by 0.018 units at 6 months and 0.025 units at 1 year of follow-up. Improvements in vitamin D status were independently associated with improvements in HRQOL and in QALYs. As per 25 nmol/L increase in 25(OH)D, there was a 0.002 increase in HRQOL and a 0.001 increase in QALYs.

Conclusions

This study documents the benefits of a real-world preventive health program to HRQOL. It is the first to reveal that improvements in vitamin D status parallel improvements in HRQOL among healthy community dwellers. The study further suggests that the preventive health program and supplementation with vitamin D are cost-effective interventions.
Literature
1.
2.
Institute of Medicine, Food and Nutrition Board. (2011). Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academies Press.
3.
4.
Ekwaru, J. P., Zwicker, J. D., Holick, M. F., Giovannucci, E., & Veugelers, P. J. (2014). The importance of body weight for the dose response relationship of oral vitamin d supplementation and serum 25-hydroxyvitamin d in healthy volunteers. PLoS ONE, 9(11), e111265.PubMedCentralCrossRefPubMed
5.
Zittermann, A., Ernst, J. B., Gummert, J. F., & Borgermann, J. (2014). Vitamin D supplementation, body weight and human serum 25-hydroxyvitamin D response: A systematic review. European Journal of Nutrition, 53(2), 367–374.CrossRefPubMed
6.
van Groningen, L., Opdenoordt, S., van Sorge, A., Telting, D., Giesen, A., & de Boer, H. (2010). Cholecalciferol loading dose guideline for vitamin D-deficient adults. European Journal of Endocrinology, 162(4), 805–811.CrossRefPubMed
7.
Vatanparast, H., Calvo, M. S., Green, T. J., & Whiting, S. J. (2010). Despite mandatory fortification of staple foods, vitamin D intakes of Canadian children and adults are inadequate. Journal of Steroid Biochemistry and Molecular Biology, 121(1–2), 301–303.CrossRefPubMed
8.
Prentice, A. (2008). Vitamin D deficiency: A global perspective. Nutrition Reviews, 66(10 Suppl 2), S153–S164.CrossRefPubMed
9.
Langlois, K., Greene-Finestone, L., Little, J., Hidiroglou, N., & Whiting, S. (2010). Vitamin D status of Canadians as measured in the 2007 to 2009 Canadian Health Measures Survey. Health Reports, 21(1), 47–55.PubMed
10.
Sohl, E., van Schoor, N. M., de Jongh, R. T., Visser, M., Deeg, D. J., & Lips, P. (2013). Vitamin D status is associated with functional limitations and functional decline in older individuals. Journal of Clinical Endocrinology and Metabolism, 98(9), E1483–E1490.CrossRefPubMed
11.
Murad, M. H., Elamin, K. B., Abu Elnour, N. O., Elamin, M. B., Alkatib, A. A., Fatourechi, M. M., et al. (2011). Clinical review: The effect of vitamin D on falls: A systematic review and meta-analysis. Journal of Clinical Endocrinology and Metabolism, 96(10), 2997–3006.CrossRefPubMed
12.
Bischoff-Ferrari, H. A., Dawson-Hughes, B., Staehelin, H. B., Orav, J. E., Stuck, A. E., Theiler, R., et al. (2009). Fall prevention with supplemental and active forms of vitamin D: A meta-analysis of randomised controlled trials. BMJ, 339, b3692.PubMedCentralCrossRefPubMed
13.
Janssen, H. C., Samson, M. M., & Verhaar, H. J. (2002). Vitamin D deficiency, muscle function, and falls in elderly people. American Journal of Clinical Nutrition, 75(4), 611–615.PubMed
14.
Bischoff-Ferrari, H. A., Willett, W. C., Orav, E. J., Lips, P., Meunier, P. J., Lyons, R. A., et al. (2012). A pooled analysis of vitamin D dose requirements for fracture prevention. New England Journal of Medicine, 367(1), 40–49.CrossRefPubMed
15.
16.
Lips, P., Wiersinga, A., van Ginkel, F. C., Jongen, M. J., Netelenbos, J. C., Hackeng, W. H., et al. (1988). The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. Journal of Clinical Endocrinology and Metabolism, 67(4), 644–650.CrossRefPubMed
17.
Anglin, R. E., Samaan, Z., Walter, S. D., & McDonald, S. D. (2013). Vitamin D deficiency and depression in adults: Systematic review and meta-analysis. British Journal of Psychiatry, 202, 100–107.CrossRefPubMed
18.
Ju, S. Y., Lee, Y. J., & Jeong, S. N. (2013). Serum 25-hydroxyvitamin D levels and the risk of depression: a systematic review and meta-analysis. J Nutr Health Aging, 17(5), 447–455.CrossRefPubMed
19.
Huang, W., Shah, S., Long, Q., Crankshaw, A. K., & Tangpricha, V. (2013). Improvement of pain, sleep, and quality of life in chronic pain patients with vitamin D supplementation. Clinical Journal of Pain, 29(4), 341–347.CrossRefPubMed
20.
Chao, Y. S., Ekwaru, J. P., Ohinmaa, A., Griener, G., & Veugelers, P. J. (2014). Vitamin D and health-related quality of life in a community sample of older Canadians. Quality of Life Research, 23(9), 2569–2575.PubMedCentralCrossRefPubMed
21.
Chao, Y. S., Brunel, L., Faris, P., & Veugelers, P. J. (2013). The importance of dose, frequency and duration of vitamin D supplementation for plasma 25-hydroxyvitamin D. Nutrients, 5(10), 4067–4078.PubMedCentralCrossRefPubMed
22.
Chao, Y. S., Brunel, L., Faris, P., & Veugelers, P. J. (2013). Vitamin D status of Canadians employed in northern latitudes. Occup Med (Lond), 63(7), 485–493.CrossRef
23.
Heaney, R. P., French, C. B., Nguyen, S., Ferreira, M., Baggerly, L. L., Brunel, L., & Veugelers, P. (2013). A novel approach localizes the association of vitamin D status with insulin resistance to one region of the 25-hydroxyvitamin D continuum. Adv Nutr, 4(3), 303–310.PubMedCentralCrossRefPubMed
24.
Oemar M., & Janssen B. (2013). EQ-5D-5L user guide basic information on how to use the EQ-5D-5L instrument.
25.
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.PubMedCentralCrossRefPubMed
26.
Tidermark, J., Zethraeus, N., Svensson, O., Tornkvist, H., & Ponzer, S. (2002). Femoral neck fractures in the elderly: functional outcome and quality of life according to EuroQol. Quality of Life Research, 11(5), 473–481.CrossRefPubMed
27.
Harris, M. (2013). Digital divide persists in Canada, both in access and Internet fluency. Financial Post.
28.
29.
Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 96(7), 1911–1930.CrossRefPubMed
30.
Vieth, R., Bischoff-Ferrari, H., Boucher, B. J., Dawson-Hughes, B., Garland, C. F., Heaney, R. P., et al. (2007). The urgent need to recommend an intake of vitamin D that is effective. American Journal of Clinical Nutrition, 85(3), 649–650.PubMed
31.
32.
Whitehead, S. J., & Ali, S. (2010). Health outcomes in economic evaluation: the QALY and utilities. British Medical Bulletin, 96, 5–21.CrossRefPubMed
33.
Bunout, D., Barrera, G., Leiva, L., Gattas, V., de la Maza, M. P., Avendano, M., & Hirsch, S. (2006). Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects. Experimental Gerontology, 41(8), 746–752.CrossRefPubMed
34.
Bolland, M. J., Grey, A., Gamble, G. D., & Reid, I. R. (2014). The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: A trial sequential meta-analysis. Lancet Diabetes Endocrinol, 2(4), 307–320.CrossRefPubMed
35.
Polak, M. A., Houghton, L. A., Reeder, A. I., Harper, M. J., & Conner, T. S. (2014). Serum 25-hydroxyvitamin D concentrations and depressive symptoms among young adult men and women. Nutrients, 6(11), 4720–4730.PubMedCentralCrossRefPubMed
36.
Signorello, L. B., McLaughlin, J. K., Lipworth, L., Friis, S., Sorensen, H. T., & Blot, W. J. (2002). Confounding by indication in epidemiologic studies of commonly used analgesics. American Journal of Therapeutics, 9(3), 199–205.CrossRefPubMed
37.
38.
Rocchi, A., Menon, D., Verma, S., & Miller, E. (2008). The role of economic evidence in Canadian oncology reimbursement decision-making: to lambda and beyond. Value Health, 11(4), 771–783.CrossRefPubMed
39.
Hazell, M. L., Morris, J. A., Linehan, M. F., & Frank, T. L. (2009). Temporal change in health-related quality of life: A longitudinal study in general practice 1999–2004. British Journal of General Practice, 59(568), 839–843.PubMedCentralCrossRefPubMed
40.
Burstrom, K., Johannesson, M., & Rehnberg, C. (2007). Deteriorating health status in Stockholm 1998–2002: Results from repeated population surveys using the EQ-5D. Quality of Life Research, 16(9), 1547–1553.CrossRefPubMed
Metadata
Title
The effectiveness of a preventive health program and vitamin D status in improving health-related quality of life of older Canadians
Authors
J. P. Ekwaru
A. Ohinmaa
Paul J. Veugelers
Publication date
01-03-2016
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 3/2016
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-015-1103-7

Other articles of this Issue 3/2016

Quality of Life Research 3/2016 Go to the issue

Special Section: PROs in Non-Standard Settings (by invitation only)

Use of weekly assessment data to enhance evaluation of a subjective wellbeing intervention

OriginalPaper

Concurrent validity of the PROMIS® pediatric global health measure

Special Section: PROs in Non-Standard Settings (by invitation only)

Evaluating a new methodology for providing individualized feedback in healthcare on quality of life and its importance, using the WHOQOL-BREF in a community population

Special Section: PROs in Non-Standard Settings (by invitation only)

Implementation of the Kids-CAT in clinical settings: a newly developed computer-adaptive test to facilitate the assessment of patient-reported outcomes of children and adolescents in clinical practice in Germany

Special Section: PROs in Non-Standard Settings (by invitation only)

Advantages and psychometric validation of proximal intensive assessments of patient-reported outcomes collected in daily life

OriginalPaper

Ambulatory and diary methods can facilitate the measurement of patient-reported outcomes