Vitamin D supplementation in older adults: Searching for specific guidelines in nursing homes |
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Authors: | Yves Rolland P de Souto Barreto G Abellan van Kan C Annweiler O Beauchet H Bischoff-Ferrari G Berrut H Blain M Bonnefoy M Cesari G Duque M Ferry O Guerin O Hanon B Lesourd J Morley A Raynaud-Simon G Ruault J -C Souberbielle B Vellas |
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Institution: | 17. Department of Geriatric Medicine, CHU Toulouse, Institute of aging, F-31059, Toulouse, France 27. Inserm, U1027, F-31073, Toulouse, France 37. Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital; UPRES EA 2646, University of Angers, UNAM, Angers, France 47. Centre on Aging and Mobility, Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland 57. Department of Geriatric Medicine, CHU, Hospital Bellier, Nantes, France 67. Department of Geriatrics, University Hospital of Montpellier, Movement to Health Laboratory Montpellier, Euromov, University of Montpellier 1, France 77. Department of Geriatric Medicine, Hospital Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France 87. Ageing Bone Research Program, Sydney Medical School Nepean, University of Sydney, Sydney, Australia 97. UMR U 557, Inserm U 1125, Inra/Cnam/Paris 13, Paris, France 107. Department of Geriatric Medicine, CHU Nice, University Nice-Sophia Antipolis, Nice, France 117. EA 4468 INSERM, Department of Geriatric Medicine, University Paris Descartes, AP-HP, h?pital Broca, Paris, France 127. Department of geriatrics, CHU Clermont-Ferrand; UPRES AME2P, University of Clermont-Ferrand, Clermont-Ferrand, France 137. Division of Geriatric Medicine, Saint Louis University, St Louis, MO, USA 147. Department of geriatrics, H?pital Bichat-Claude-Bernard, Paris, France 157. French Society of Geriatrics and Gerontology (SFGG), Paris, France 167. Department of functional exploration, H?pital Necker-Enfants malades, Assistance Publique-H?pitaux de Paris (AP-HP), Paris, France
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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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