Nutritional Hypovitaminosis‐D and the Genesis of Osteomalacia in the Elderly

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Abstract
The genesis of osteomalacia due to dietary lack of vitamin D in the elderly in the UK was reviewed. Subjects at high risk were identified and the diagnostic difficulties discussed. The importance of dietary vitamin D and exposure to sunlight in relation to vitamin status was stressed. The role of vitamin D in Ca metabolism is now much more clearly defined; the final active form of the vitamin is 1,25-dihydroxy-vitamin D, which acts like a hormone after the vitamin molecule has undergone 2 chemical modifications in the liver and kidney. A correlation between lack of vitamin D and femoral neck fractures was established. Six illustrative cases of osteomalacia in the elderly due to dietary lack of vitamin D were reported.