Medline ® Abstract for Reference 32
of 'Vitamin D deficiency in adults: Definition, clinical manifestations, and treatment'
Vitamin D deficiency in residents of academic long-term care facilities despite having been prescribed vitamin D.
Hamid Z, Riggs A, Spencer T, Redman C, Bodenner D
J Am Med Dir Assoc. 2007;8(2):71. Epub 2006 Oct 27.
OBJECTIVES: Vitamin D is vitally important in maintaining skeletal health. A low plasma vitamin D concentration is associated with increased parathyroid hormone secretion, increased bone turnover, osteomalacia, and osteoporosis. As a result, vitamin D deficiency is associated with a higher incidence of hip and other fractures. Although Vitamin D deficiency has been reported in long-term care facilities, optimal methods of replenishment have not been defined. The objective of the present study was to identify the pattern of calcium and vitamin D supplementation in nursing home residents and to identify vitamin D deficiency in residents already on supplement therapy.
DESIGN: Retrospective chart review.
SETTING: Five academic nursing homes staffed by faculty from the University of Arkansas for Medical Sciences.
PARTICIPANTS: Elderly residents aged 65 and older receiving calcium and vitamin D supplements.
MEASUREMENTS: Data on dose, frequency, and levels of calcium and vitamin D were collected. The medication list and creatinine levels were also recorded.
RESULTS: Forty-four (40%) residents were receiving 1000 mg, 48 (44%) were receiving 1200 mg, and 9 (8.2%) were receiving 1500 mg of calcium carbonate. Similarly, 79 (72%) residents were on 400 IU, 13 (12%) were on 600 IU, and only 8 (7%) were on 800 IU of vitamin D3 (cholecalciferol). Low levels of Vitamin D 25 (OH) D (values<30 ng/mL) were identified in 49.4% of residents; 16% were found to have deficiency (<20 ng/mL).
CONCLUSION: Despite clear benefit, nursing home residents were not supplemented adequately with calcium and vitamin D.
Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.