Sohl et al developed 2 scores for identifying an older adult who may be vitamin D deficient. These can help to select a patient who may benefit from further assessment. The authors are from the EMGO Institute for Health and Care Research, University Medical Center Amsterdam and VU University in Amsterdam, the Netherlands.
Patient selection: age >= 65 years
Outcome: serum 25-OH-vitamin D less than 30 mmol/L
Parameters:
(1) age in years
(2) smoker
(3) alcohol use in standard drinks per week
(4) season of the year
(5) vitamin user
(6) bicycle rider
(7) gardener
(8) medications taken
(9) limitations in transport use
(10) remembers year
|
Parameter |
Finding |
Points |
|
age in years |
|
2 * MAX(0,(age) – 65) |
|
smoker |
no |
0 |
|
|
yes |
13 |
|
alcohol intake |
< 13 drinks per week |
28 |
|
|
>= 13 drinks/week |
0 |
|
season |
summer |
0 |
|
|
autumn |
1 |
|
|
winter |
21 |
|
|
spring |
13 |
|
vitamin use |
no |
20 |
|
|
yes |
0 |
|
bicycler |
no |
20 |
|
|
yes |
0 |
|
gardening |
no |
21 |
|
|
yes |
0 |
|
medication use |
no |
0 |
|
|
yes |
9 |
|
limitations in transport use |
no |
0 |
|
|
yes |
12 |
|
remembers year |
no |
15 |
|
|
yes |
0 |
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: age-dependent. For 65 year old – 169. For 100 year old -239.
• The higher the score the greater the risk of being vitamin D deficient.
Performance:
• The area under the ROC curve: 0.80
• Using a cutoff of 110 (> 110 vitamin D deficient), the sensitivity was 61% and specificity 84%. The Youden score is 0.45.
• The points for season and for outdoor activities would have to be modified for latitude.
• The points for lifestyle would have to be modified for race.
Specialty: Nutrition
