Are residents in licensed residential centres at increased risk of vitamin D deficiency

Low vitamin D levels are being detected in residents of licensed residential centres, which cater for people with psychiatric and developmental disabilities, in central Sydney. Few reports of vitamin D deficiency are recorded in Australia and New Zealand, except in nursing home residents, although this is a common problem overseas in countries with a colder climate and less exposure to sunlight. Vitamin D is essential for skeletal health and severe deficiency is associated with defective mineralisation of bones leading to rickets in children or osteomalacia (or adult rickets) in adults. Low levels of vitamin D can also lead to secondary hyperparathyroidism and increased bone turnover, which are thought to have important roles in age-related bone loss and fractures. The literature review and case study presented, suggests that this disadvantaged population with psychiatric and/or developmental disabilities in licensed residential centres may have increased risk factors for vitamin D deficiency. Vitamin D deficiency can be easily detected and treated. However, if diagnosis is delayed, the long-term consequences of osteomalacia and fractures are more difficult and costly to treat. The risk factors for vitamin D deficiency may also be relevant for housebound older people in the community and in hostels. Further research is needed to determine the prevalence of vitamin D deficiency in Australia and the best methods of prevention and treatment in at risk populations. (author abstract)