scholarly journals Efficacy of various prescribed vitamin D supplementation regimens on 25-hydroxyvitamin D serum levels in long-term care

2021 ◽  
pp. 1-24
Author(s):  
Ronna N Robbins ◽  
Monica Serra ◽  
Nalini Ranjit ◽  
Deanna M Hoelscher ◽  
Sara J Sweitzer ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Long Term Care ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Serum Concentrations ◽  
Blood Draw ◽  
Term Care ◽  
Hydroxyvitamin D

ABSTRACT Objective: The aims of this study were to examine the efficacy among various vitamin D supplementation regimens on serum 25(OH)D concentrations and determine the minimal dose rate required to achieve sufficient serum concentrations (≥75 nmol/L) among older adults in long-term care (LTC). Design: A one-year medical history was abstracted from medical records, and a one-time blood draw to measure serum 25(OH)D concentrations was obtained. Individuals were stratified into vitamin D supplemented and non-supplemented groups. The supplemented group was further categorized into four treatment forms: single ingredient vitamin D2or3, multivitamin, calcium with vitamin D, or combination of the three, and by daily prescribed doses: 0-399, 400-799, 800-1999, 2000-3999, and >4000 IU/day. Setting: Five LTC communities in Austin, Texas. Participants: 173 older (≥65 years) adults. Results: Of the participants, 62% received a vitamin D supplement and 55% had insufficient (≤75 nmol/L) 25(OH)D serum concentrations. Individuals receiving single ingredient vitamin D2or3 supplementation received the highest daily vitamin D mean dose (2900 IU/d), while combination of forms was the most frequent treatment (44%) with the highest mean serum concentration (108 nmol/L). All supplementation doses were successful at reaching sufficient serum concentrations, except those <800 IU/d. Using a prediction model, it was observed that one IU/d of vitamin D supplementation resulted in a 0.008 nmol/L increase in serum 25(OH)D concentrations. Conclusion: Based on the predictive equation, results suggest that supplementation of 1500 IU/d of vitamin D2or3 or combination of vitamin D is most likely to achieve sufficient serum 25(OH)D concentrations in older adults in LTC.

scholarly journals Vitamin D Supplementation for the Prevention and/or Treatment of Cardiovascular Disease, Cancer, and Other Conditions in Residents of Long-Term Care Facilities

2021 ◽  
Vol 1 (7) ◽  
Author(s):  
Keeley Farrell ◽  
Jennifer Horton
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Vitamin D ◽  
Long Term Care ◽  
Respiratory Infections ◽  
Vitamin D Supplementation ◽  
Term Care ◽  
Care Facilities

The results of 1 systematic review suggest that supplementation with vitamin D may provide some benefit for cancer-related mortality in older adults. It is unclear whether there is a benefit of vitamin D supplementation for all-cause mortality; however, no benefit was found for cardiovascular disease mortality, cardiovascular disease events, or cancer incidence. There is limited and mixed evidence on the effectiveness of vitamin D supplementation for dementia and mild cognitive impairment in older adults. The results of 1 systematic review suggest that vitamin D supplementation may provide protection against acute respiratory infections in the overall population; however, this result was not significant in the subgroup of patients older than 65 years. No evidence-based guidelines were identified regarding vitamin D supplementation for the prevention and/or treatment of cardiovascular disease, cancer, and other conditions in elderly patients residing in long-term care facilities.

Use of vitamin and mineral supplements in long-term care home residents

2012 ◽  
Vol 37 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Navita Viveky ◽  
Lynda Toffelmire ◽  
Lilian Thorpe ◽  
Jennifer Billinsky ◽  
Jane Alcorn ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Long Term Care ◽  
Care Home ◽  
Care Facility ◽  
Dementia Diagnosis ◽  
Term Care ◽  
Supplement Use ◽  
Supplement Usage

Vitamin–mineral supplementation may offer older adults health and cognition-related benefits but overuse may contribute to polypharmacy. We examined the prevalence of supplement usage in long-term care facility (LTC) residents (≥65 years of age). As cognition may be affected by nutrition, we also examined use in those with diagnosis of dementia and those with no dementia diagnosis. The prevalence of supplement usage and overall “pill count” from pharmaceutical use was assessed in 189 LTC residents and a subsample of 56 older adults with dementia diagnosis, respectively. Participants were residing in an LTC facility of a mid-size metropolitan area during 2009. The average use of supplements was 1.0 per day for all residents, with 35% taking vitamin D supplements, 20% multivitamins, and 26% calcium. Supplement use was similar (p ≥ 0.05) for those with dementia diagnosis (53%, average 2.0 per day) and for those without such diagnosis (45%, average 2.2 per day). Usage ranged between 1–6 supplements per day. In both of these groups, ∼73% of users were taking vitamin D. The number of prescribed medications ranged from 4 to 24 (average 10.2) in a subsample of residents whose supplement intake was 0 to 6 (average 2). These findings suggest an overall low rate of supplement use, with no significant differences (p ≥ 0.05) in use between residents with and without dementia diagnosis. However, some residents were at risk for supplement overuse.

scholarly journals Vitamin D Supplementation for the Prevention of Falls and Fractures in Residents of Long-Term Care Facilities: A 2021 Update

2021 ◽  
Vol 1 (7) ◽  
Author(s):  
Srabani Banerjee ◽  
Holly Gunn ◽  
Carolyn Spry
Keyword(s):  
Vitamin D ◽  
Elderly Patients ◽  
Systematic Reviews ◽  
Long Term Care ◽  
Vitamin D Supplementation ◽  
Term Care ◽  
Care Facilities ◽  
Overview Of Systematic Reviews ◽  
Evidence Based Guidelines

The relevant publications identified comprised 1 overview of systematic reviews and 2 systematic reviews. There is a suggestion that for seniors living in long-term care facilities, compared to control, vitamin D supplementation, with or without calcium, may reduce the rate of falls and fractures; however, the reductions were not always statistically significant. There were no statistically significant differences in the number of seniors who fell with vitamin D supplementation, with or without calcium, compared with control groups. Findings need to be interpreted with caution, considering the limitations such as primary studies of variable quality (critically low to moderate) and lack of clarity with respect to the type of long-term care setting. No cost-effectiveness studies regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified. No evidence-based guidelines regarding vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities were identified.

Predictors of hip fractures and mortality in long-term care homes in Saskatchewan: Does vitamin D supplementation play a role?

2020 ◽  
Vol 200 ◽  
pp. 105654
Author(s):  
Susan J. Whiting ◽  
Wenbin Li ◽  
Nirmal Singh ◽  
Jacqueline Quail ◽  
William Dust ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hip Fractures ◽  
Long Term Care ◽  
Vitamin D Supplementation ◽  
Care Homes ◽  
Term Care

scholarly journals Prevalence of Insufficient Serum 25-hydroxyvitamin D (25(OH)D) Greater Among Medicaid Residents Living in Long-Term Care Communities (P01-011-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ronna Robbins ◽  
Nalini Ranjit ◽  
Sara Sweitzer ◽  
Maragaret Briley
Keyword(s):  
Logistic Regression ◽  
Serum Level ◽  
Medical Records ◽  
Long Term Care ◽  
Serum Levels ◽  
Term Care ◽  
Hydroxyvitamin D ◽  
Payer Source ◽  
25 Hydroxyvitamin D

Abstract Objectives Evaluate the association between insufficient 25-hydroxyvitamin D [25(OH)D] serum levels and healthcare payer source of older adults living in long-term care (LTC) communities. Methods Residents (age >65 yo) of five LTC communities in Central, Texas were recruited to participated in the multi-site, cross-sectional study. A one-year medical history was abstracted from medical records using double-blinded data abstraction and entry protocols. Medical history included but not limited to: diagnosis, medications, history of supplementation, BMI, mini-nutritional assessment, diet order, total mood assessments, hospitalizations and number of infections. Data on payer source and other demographics were also obtained via medical records. Blood draws were collected to measure serum 25(OH)D levels. Logistic regression models were uses to assess the association between insufficient25(OH)Dserum levels (defined as <30 ng/ml) and healthcare payer source. Total vitamin D supplemented per day along with amount provided in meals, body mass index, race, gender, age, years living in community, and diagnosis of liver and renal disease were used as confounders. Results The 174 participants (89% Caucasian, mean age 83 yo) included 63% females. Payer source was distributed as follows: 55% private pay, 8.6% Medicare, 35% Medicaid, and 1% insurance. Fifty-five % had insufficient25(OH)D serum levels (mean serum level = 32.6 ng/ml; mean supplementation rate of 1138 IU per/d). Insufficient serum levels were seen in 48% of participants with private pay (mean serum level = 36 mg/ml) and 58% with Medicaid (mean serum level = 30.5 ng/ml). Adjusted logistic regression showed that payer source was a significant determinant of insufficient25(OH)D serum levels. Medicaid residents had significantly greater odds of having insufficient 25(OH)D serum levels (adjusted odd ratio (OR) 3.26; CL: 1.25, 8.48; P = 0.015) than private pay participants. Conclusions Practitioners working in LTC can use these results to ensure equity in the provision of medical nutritional therapy across Medicaid residents and private pay residents. Funding Sources Funding for study was provided through the private funds of research team.

scholarly journals SERUM 25(OH)D SIGNIFICANTLY IMPACTS ALZHEIMER’S DISEASE IN OLDER ADULTS LIVING IN LONG-TERM CARE COMMUNITIES.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S863-S863
Author(s):  
Robert A Churchill ◽  
Ronna Robbins ◽  
Nalini Ranjit ◽  
Sara Sweitzer ◽  
Margaret Briley
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Vitamin D Supplementation ◽  
Cross Sectional ◽  
Term Care ◽  
Logistic Regression Models ◽  
Hydroxyvitamin D

Abstract 6.08 million Americans suffer from Alzheimer’s Disease (AD), with some estimating diagnoses will reach 15.0 million by 2060. Age is the strongest risk factor for AD, and the prevalence of AD among older adults necessitates investigation into preventable risk factors. 25-hydroxyvitamin D [25(OH)D] deficiency is more prevalent in older adults than other age demographics. Research shows a strong correlation between deficient 25(OH)D serum levels (≤20ng/ml) and AD diagnosis. The association with insufficient (≤30 ng/ml) levels remains unclear. Older adults (age &gt; 65 yo) of five LTC communities in Texas participated in the cross-sectional study. One-year medical history and demographics were abstracted from medical records using double-blinded data abstraction and entry. Blood draws measured 25(OH)D serum levels. Adjusted logistic regression models examined if insufficient 25(OH)D serum levels (≤30 ng/ml) are associated with AD diagnosis. Confounders were total daily vitamin D supplementation, BMI, race, gender, age, years in community, and diagnosis of liver and renal disease. Participants (n=174, mean age: 83 yo) consisted of 63% female and 89% Caucasian. Fifty five percent had insufficient serum 25(OH)D levels (mean level: 32.6 ng/ml; mean supplementation rate: 1,138 IU per/d), and 20% had diagnosis of AD. 25% had both insufficient serum levels and AD, while 12.6% had adequate serum levels and AD. Those with insufficient 25(OH)D serum levels had elevated odds (OR=2.8; CL: 1.14, 7.02; p=0.024) of having AD after adjusting for confounders. Insufficient serum 25(OH)D levels (≤30 ng/ml) are associated with increased diagnoses of AD, indicating the importance of adequate levels among LTC residents.

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