[Vitamin D in geriatric patients].

Area of Science:

• Geriatric Medicine
• Nutritional Science
• Bone Health

Background:

• Vitamin D deficiency is highly prevalent in geriatric patients, exceeding 80% in those with hip fractures.
• Factors contributing to deficiency include reduced sun exposure, skin aging, immobility, and institutionalization.
• Vitamin D deficiency (<20 ng/ml) elevates parathyroid hormone, exacerbating bone loss and fracture risk, while severe deficiency (<10 ng/ml) can cause muscle weakness and falls.

Purpose of the Study:

• To highlight the significance of vitamin D deficiency in geriatric patients.
• To review the evidence for vitamin D supplementation in reducing falls and fractures.
• To provide recommendations for optimal vitamin D supplementation strategies in the elderly.

Main Methods:

• Analysis of randomized intervention trials comparing vitamin D dosages (800-1000 IU/day) with placebo or calcium.
• Inclusion of data from adults aged 65 and older with increased risk of vitamin D deficiency, falls, or fractures.
• Critical review of four recent meta-analyses on vitamin D supplementation in the elderly.

Main Results:

• Daily vitamin D supplementation of 800-1000 IU demonstrated a significant reduction in falls and hip fractures in at-risk older adults.
• High-dose bolus vitamin D (over 24,000 IU/month) was associated with an increased risk of falls and fractures.
• The findings support the efficacy of consistent, moderate-dose vitamin D supplementation.

Conclusions:

• Correction of vitamin D deficiency is a crucial public health objective in geriatric populations.
• Daily supplementation with 800-1000 IU of vitamin D is the preferred strategy for geriatric patients at risk.
• Avoidance of high-dose monthly bolus vitamin D is recommended to prevent adverse outcomes like increased falls and fractures.