Osteoporosis International, 12/16/2016
In this study, physicians tried to evaluate the effect of daily supplementation on vitamin D deficiency, function, and falls in female long–term care residents. It was resulted out that institute of medicine guidelines may not be adequate for frail elderly. Future research of optimal 25(OH) D levels for maintaining function and preventing falls is needed.
Methods
- They recruited female long–term care residents aged ≥65 in an osteoporosis clinical trial were included in this analysis (n = 137).
- They categorized participants based on baseline 25(OH) D levels as deficient (<20 ng/ml, n = 26), insufficient (20–30 ng/ml, n = 40), or sufficient (>30 ng/ml, n = 71).
- They served initial vitamin D repletion (50,000 IU D3 weekly for 8 weeks) to deficient women.
- further, all were supplemented with 800 IU vitamin D3 daily for 24 months.
- Annual functional assessments included Activities of Daily Living (ADLs), Instrumental ADL (IADL), physical performance test (PPT), gait speed, cognition (SPMSQ), and mental health (PHQ–9).
- They applied linear mixed models for analysis of functional measures and logistic regression for falls.
Results
- Daily supplementation maintained 25(OH) D levels above 20 ng/ml in 95% of participants.
- According to the findings, all groups indicated functional decline.
- It was resulted out that women initially deficient had a greater decline in physical function at 12 (IADL –2.0 ± 0.4, PPT –3.1 ± 0.7, both p < 0.01) and 24 months (IADL –2.5 ± 0.6, ADL -2.5 ± 0.6, both p < 0.01), a larger increase in cognitive deficits at 12 months (1.7 ± 0.4: p = 0.01) and more fallers (88.5%, p = 0.04) correlated to those sufficient at baseline, despite supplementation to sufficient levels.