Rebeka Arnljots´s research

Summary of the PhD thesis: Vitamin D, bacteriuria and nonspecific symptoms among elderly residents of nursing homes

Background

Vitamin D deficiency, nonspecific symptoms and bacteriuria are common among elderly residents of nursing homes. Vitamin D is a modulator of the immune system and also involved in the protection of the epithelium in the urinary tract. The associations between vitamin D deficiency, nonspecific symptoms and bacteriuria respectively are not clearly established. Nonspecific symptoms such as fatigue, anxiety and confusion are usually not caused by acute cystitis. Despite this nonspecific symptoms, in the absence of newly onset focal urinary tract symptoms, all too often lead to antibiotic treatments.

Method
Paper 1: A cross-sectional study of elderly residents of Swedish nursing homes to investigate the prevalence of vitamin D deficiency and to identify associated factors such as: skin phototype, hours spent outdoors per week, lack of appetite, vitamin D supplementation, dementia and antibiotic treatments.

Paper 2: A cross-sectional study of elderly residents of nursing homes to investigate if there is an association between bacteriuria and vitamin D deficiency.

Paper 3: The aim of this study is to investigate the association between long-lasting nonspecific symptoms (often misinterpreted as acute cystitis) and vitamin D concentrations.

Paper 4: To design an antimicrobial stewardship intervention aiming to reduce antibiotic overuse for suspected urinary tract infections in elderly and to conduct a randomized controlled trial evaluating this intervention.

Relevance
This thesis is expected to increase the knowledge regarding vitamin D deficiency, nonspecific symptoms and bacteriuria among elderly residents of nursing homes, potentially leading to improved rational prescribing of antibiotics in nursing homes.

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Supervisor: Pär-Daniel Sundvall