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

  • Published:
The journal of nutrition, health & aging

Abstract

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.

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Authors and Affiliations

  1. Department of Geriatric Medicine, CHU Toulouse, Institute of aging, F-31059, Toulouse, France

    Yves Rolland, P. de Souto Barreto, G. Abellan van Kan, M. Cesari & B. Vellas

  2. Inserm, U1027, F-31073, Toulouse, France

    Yves Rolland, M. Cesari & B. Vellas

  3. Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital; UPRES EA 2646, University of Angers, UNAM, Angers, France

    C. Annweiler & O. Beauchet

  4. Centre on Aging and Mobility, Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland

    H. Bischoff-Ferrari

  5. Department of Geriatric Medicine, CHU, Hospital Bellier, Nantes, France

    G. Berrut

  6. Department of Geriatrics, University Hospital of Montpellier, Movement to Health Laboratory Montpellier, Euromov, University of Montpellier 1, France

    H. Blain

  7. Department of Geriatric Medicine, Hospital Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France

    M. Bonnefoy

  8. Ageing Bone Research Program, Sydney Medical School Nepean, University of Sydney, Sydney, Australia

    G. Duque

  9. UMR U 557, Inserm U 1125, Inra/Cnam/Paris 13, Paris, France

    M. Ferry

  10. Department of Geriatric Medicine, CHU Nice, University Nice-Sophia Antipolis, Nice, France

    O. Guerin

  11. EA 4468 INSERM, Department of Geriatric Medicine, University Paris Descartes, AP-HP, hôpital Broca, Paris, France

    O. Hanon

  12. Department of geriatrics, CHU Clermont-Ferrand; UPRES AME2P, University of Clermont-Ferrand, Clermont-Ferrand, France

    B. Lesourd

  13. Division of Geriatric Medicine, Saint Louis University, St Louis, MO, USA

    J. Morley

  14. Department of geriatrics, Hôpital Bichat-Claude-Bernard, Paris, France

    A. Raynaud-Simon

  15. French Society of Geriatrics and Gerontology (SFGG), Paris, France

    G. Ruault

  16. Department of functional exploration, Hôpital Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

    J. -C. Souberbielle

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  1. Yves Rolland
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  2. P. de Souto Barreto
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  19. J. -C. Souberbielle
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  20. B. Vellas
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Rolland, Y., de Souto Barreto, P., van Kan, G.A. et al. Vitamin D supplementation in older adults: Searching for specific guidelines in nursing homes. J Nutr Health Aging 17, 402–412 (2013). https://doi.org/10.1007/s12603-013-0007-x

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