Vitamin D supplementation in older adults: Searching for specific guidelines in nursing homes

BACKGROUND: The prevalence of vitamin D insufficiency is very high in the nursing home (NH) population. Paradoxically, vitamin D insufficiency is rarely treated despite of strong clinical evidence and recommendations for supplementation. This review aims at reporting the current knowledge of vitamin...

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Bibliographic Details
Published in:The Journal of nutrition, health & aging health & aging, 2013-04, Vol.17 (4), p.402-412
Main Authors: Rolland, Yves, de Souto Barreto, P, van Kan, G. Abellan, Annweiler, C, Beauchet, O, Bischoff-Ferrari, H, Berrut, G, Blain, H, Bonnefoy, M, Cesari, M, Duque, G, Ferry, M, Guerin, O, Hanon, O, Lesourd, B, Morley, J, Raynaud-Simon, A, Ruault, G, Souberbielle, J. -C, Vellas, B
Format: Article
Language:English
Subjects:
adverse effects
Aged
Aging
Biological and medical sciences
calcium
Calcium, Dietary - administration & dosage
Calcium, Dietary - blood
cost effectiveness
Dietary Supplements
elderly
Feeding. Feeding behavior
food intake
Fractures
Fundamental and applied biological sciences. Psychology
Geriatric Assessment
Geriatrics
Geriatrics/Gerontology
Gerontology
guidelines
Homes for the Aged
Hospitals
Humans
Life Sciences
Medicine
Medicine & Public Health
Neurosciences
Nursing Homes
Nutrition
Nutritional Status
Older people
patients
Polypharmacy
Practice Guidelines as Topic
Primary Care Medicine
Quality of Life Research
risk
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Vitamin D
Vitamin D - administration & dosage
Vitamin D - blood
Vitamin D Deficiency - blood
Vitamin D Deficiency - drug therapy
Vitamin D Deficiency - epidemiology
vitamin deficiencies
Vitamin deficiency
vitamin supplements
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Summary:BACKGROUND: The prevalence of vitamin D insufficiency is very high in the nursing home (NH) population. Paradoxically, vitamin D insufficiency is rarely treated despite of strong clinical evidence and recommendations for supplementation. This review aims at reporting the current knowledge of vitamin D supplementation in NH and proposing recommendations adapted to the specificities of this institutional setting. DESIGN: Current literature on vitamin D supplementation for NH residents was narratively presented and discussed by the French Group of Geriatrics and Nutrition. RESULT: Vitamin D supplementation is a safe and well-tolerated treatment. Most residents in NH have vitamin D insufficiency, and would benefit from vitamin D supplement. However, only few residents are actually treated. Current specific and personalized protocols for vitamin D supplementation may not be practical for use in NH settings (e.g., assessment of serum vitamin D concentrations before and after supplementation). Therefore, our group proposes a model of intervention based on the systematic supplementation of vitamin D (1,000 IU/day) since the patient’s admission to the NH and throughout his/her stay without the need of a preliminary evaluation of the baseline levels. Calcium should be prescribed only in case of poor dietary calcium intake. CONCLUSION: A population-based rather than individual-based approach may probably improve the management of vitamin D insufficiency in the older population living in NH, without increasing the risks of adverse health problems. The clinical relevance and cost effectiveness of this proposal should be assessed under NH real-world conditions to establish its feasibility.
ISSN:1279-7707
1760-4788
DOI:10.1007/s12603-013-0007-x