Assessing the Predictive Value of Serum Vitamin D Levels for Hip Fracture Risk in Older Adults and Identifying Associated Risk Factors

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Background As the elderly population continues to grow globally, the incidence of hip fractures among this demographic is becoming an increasingly pressing public health issue. Hip fractures often result from a complex interplay of factors, including sociodemographic variables, clinical comorbidities, medication use, physical activity, and vitamin D levels. Understanding these factors is essential to mitigating the risk of hip fractures in older individuals. Objective This study aims to explore the relationship between vitamin D levels and hip fracture risk in elderly patients, identifying the clinical, demographic, and environmental factors contributing to fracture risk, with a particular focus on the role of vitamin D in bone health. Methodology This cross-sectional observational study was conducted at Mardan Medical Complex between January 2024 and February 2025. A total of 119 older adult patients (aged 50 years and above) with confirmed hip fractures were included. Demographic data, comorbidities, vitamin D levels, and relevant biomarkers were collected. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured using electrochemiluminescence immunoassay. Statistical analysis, including ANOVA, Mann-Whitney U tests, and decision tree modeling, was employed to assess the relationship between vitamin D and other variables, including BMI, mobility, supplementation, and comorbidities. Results The study found a high prevalence of vitamin D deficiency among older adult patients with hip fractures, with the average serum vitamin D level measured at 15.01 ± 5.51 ng/mL, significantly lower than the recommended levels. Key factors such as Body Mass Index (BMI) (28.27 ± 5.67) and mobility status (59 patients, 49.58% using mobility aids), as well as comorbidities like diabetes (76 patients, 63.87%) and chronic kidney disease (18 patients, 15.13%), were significantly associated with lower vitamin D levels. Vitamin D supplementation, with an average intake of 505.99 ± 284.26 IU/day, was taken by 68 patients (57.14%) and showed a positive effect on serum levels, but the variability in response (ranging from non-users to varying doses) highlighted the need for personalized supplementation strategies. Additionally, age (67.53 ± 10.51 years) and gender (69 males, 57.98%, and 50 females, 42.02%) did not show a significant impact on vitamin D levels or fracture risk in this study. Conclusion This study supports the importance of vitamin D as a modifiable risk factor for hip fractures in older adult patients. It underscores the need for comprehensive public health strategies, including regular vitamin D screening, targeted supplementation, and management of comorbidities, to reduce fracture risk in aging populations.

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