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 50 mmol/L
Parameters:
(1) age in years
(2) gender
(3) body mass index in kg per square meter
(4) smoker
(5) alcohol use in standard drinks per week
(6) season of the year
(7) vitamin user
(8) bicycle rider
(9) sport participant
(10) gardener
(11) medications taken
(12) appetite present
(13) partner status
|
Paramete |
Finding |
Points |
|
age in years |
|
MAX(0,(age) – 65) |
|
gender |
male |
0 |
|
|
female |
6 |
|
BMI |
<= 30 kg per sq m |
0 |
|
|
> 30 |
4 |
|
smoker |
no |
0 |
|
|
yes |
5 |
|
alcohol intake |
< 13 drinks per week |
6 |
|
|
>= 13 drinks/week |
0 |
|
season |
summer |
0 |
|
|
autumn |
3 |
|
|
winter |
12 |
|
|
spring |
15 |
|
vitamin use |
no |
9 |
|
|
yes |
0 |
|
bicycler |
no |
8 |
|
|
yes |
0 |
|
sports |
no |
5 |
|
|
yes |
0 |
|
gardening |
no |
8 |
|
|
yes |
0 |
|
medication use |
no |
0 |
|
|
yes |
4 |
|
appetite |
no |
4 |
|
|
yes |
0 |
|
lives with partner |
no |
5 |
|
|
yes |
0 |
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: age-dependent. For 65 year old – 79. For 100 year old -114.
• The higher the score the greater the risk of being vitamin D deficient.
|
Score |
Probability Deficient |
|
0 to 10 |
< 1% |
|
11 to 20 |
9% |
|
21 to 30 |
13% |
|
31 to 40 |
21% |
|
41 to 50 |
40% |
|
51 to 60 |
56% |
|
61 to 70 |
72% |
|
> 70 |
90% |
baed on Figure 1, page 1093
Performance:
• The area under the ROC curve: 0.71 (external validation), 0.78 (initial)
• Using a cutoff of 58 (> 58 vitamin D deficient), the sensitivity was 61% and specificity 82%. The Youden score is 0.42.
• 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
