{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:32:20Z","timestamp":1791757940549,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000320","name":"Alzheimer's Society","doi-asserted-by":"publisher","award":["AS\u2010JF\u201016b\u2010007"],"award-info":[{"award-number":["AS\u2010JF\u201016b\u2010007"]}],"id":[{"id":"10.13039\/501100000320","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007155","name":"Medical Research Council Canada","doi-asserted-by":"publisher","award":["MR\/M023095\/1"],"award-info":[{"award-number":["MR\/M023095\/1"]}],"id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["NIA R24AG054259 \u2010 NIDUS subaward 9581"],"award-info":[{"award-number":["NIA R24AG054259 \u2010 NIDUS subaward 9581"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND\/OBJECTIVES<\/jats:title>\n                    <jats:p>Delirium is common in older adults, especially following hospitalization. Because low vitamin D levels may be associated with increased delirium risk, we aimed to determine the prognostic value of blood vitamin D levels, extending our previous genetic analyses of this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Prospective cohort analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Community\u2010based cohort study of adults from 22 cities across the United Kingdom (the UK Biobank).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Adults aged 60 and older by the end of follow\u2010up in the linked hospital inpatient admissions data, up to 14\u2009years after baseline (n = 351,320).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>At baseline, serum vitamin D (25\u2010OH\u2010D) levels were measured. We used time\u2010to\u2010event models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between vitamin D deficiency and incident hospital\u2010diagnosed delirium, adjusted for age, sex, assessment month, assessment center, and ethnicity. We performed Mendelian randomization genetic analysis in European participants to further investigate vitamin D and delirium risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 3,634 (1.03%) participants had at least one incident hospital\u2010diagnosed delirium episode. Vitamin D deficiency (&lt;25\u2009nmol\/L) predicted a large incidence in delirium (HR = 2.49; 95% CI = 2.24\u20132.76;\n                      <jats:italic>P<\/jats:italic>\n                      =\u20093*10\n                      <jats:sup>\u221268<\/jats:sup>\n                      , compared with &gt;50\u2009nmol\/L). Increased risk was not limited to the deficient group: insufficient levels (25\u201350\u2009nmol\/L) were also at increased risk (HR = 1.38; 95% CI = 1.28\u20131.49;\n                      <jats:italic>P<\/jats:italic>\n                      =\u20094*10\n                      <jats:sup>\u221218<\/jats:sup>\n                      ). The association was independent of calcium levels, hospital\u2010diagnosed fractures, dementia, and other relevant cofactors. In genetic analysis, participants carrying more vitamin D\u2013increasing variants had a reduced likelihood of incident delirium diagnosis (HR = .80 per standard deviation increase in genetically instrumented vitamin D: .73\u2013.87;\n                      <jats:italic>P<\/jats:italic>\n                      =\u20092*10\n                      <jats:sup>\u22127<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Progressively lower vitamin D levels predicted increased risks of incident hospital\u2010diagnosed delirium, and genetic evidence supports a shared causal pathway. Because low vitamin D levels are simple to detect and inexpensive and safe to correct, an intervention trial to confirm these results is urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16853","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T11:23:33Z","timestamp":1601897013000},"page":"365-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Low Vitamin D Levels and Risk of Incident Delirium in 351,000 Older\n                    <scp>UK<\/scp>\n                    Biobank Participants"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3332-8454","authenticated-orcid":false,"given":"Luke C.","family":"Pilling","sequence":"first","affiliation":[{"name":"Epidemiology &amp; Public Health Group University of Exeter  Exeter UK"},{"name":"UConn Center on Aging University of Connecticut  Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay C.","family":"Jones","sequence":"additional","affiliation":[{"name":"Epidemiology &amp; Public Health Group University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane A. H.","family":"Masoli","sequence":"additional","affiliation":[{"name":"Epidemiology &amp; Public Health Group University of Exeter  Exeter UK"},{"name":"Healthcare for Older People Royal Devon and Exeter NHS Foundation Trust  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1648-871X","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Delgado","sequence":"additional","affiliation":[{"name":"Epidemiology &amp; Public Health Group University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice L.","family":"Atkins","sequence":"additional","affiliation":[{"name":"Epidemiology &amp; Public Health Group University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Bowden","sequence":"additional","affiliation":[{"name":"Exeter Diabetes Group (ExCEED), College of Medicine and Health University of Exeter  Exeter UK"},{"name":"MRC Integrative Epidemiology Unit University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard H.","family":"Fortinsky","sequence":"additional","affiliation":[{"name":"UConn Center on Aging University of Connecticut  Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Kuchel","sequence":"additional","affiliation":[{"name":"UConn Center on Aging University of Connecticut  Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Melzer","sequence":"additional","affiliation":[{"name":"Epidemiology &amp; Public Health Group University of Exeter  Exeter UK"},{"name":"UConn Center on Aging University of Connecticut  Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-1927"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.12324"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa040"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03671.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60688-1"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2009.24"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15012"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-016-0405-0"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007136"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53120.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001779"},{"key":"e_1_2_6_13_1","unstructured":"UK Biobank.UK Biobank companion document for serum biomarker data.http:\/\/biobank.ctsu.ox.ac.uk\/crystal\/refer.cgi?id=1227. 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