Effectiveness and safety of a high-dose weekly vitamin D (20,000 iu) protocol in older adults living in residential care

• Autores: Fabio Feldman, Crystal Moore, Liz da Silva, Gina Gaspard, Larry Gustafson, Sonia Singh, Susan I. Barr, David D. Kitts, Wangyang Li, Hope A. Weiler, Timothy J. Green
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 62, Nº. 8, 2014, págs. 1546-1550
• Idioma: inglés
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• Resumen

  • Objectives: To report 25 hydroxyvitamin D (25OHD) concentrations, an indicator of vitamin D status, in older adults living in residential care 1 year after a protocol of weekly 20,000 IU of vitamin D was started.

    Design: Cross-sectional.

    Setting: Five residential care facilities in British Columbia, Canada.

    Participants: Residents aged 65 and older from five facilities (N = 236).

    Measurements: Participants provided a blood sample. Demographic and health information was obtained from the medical record.

    Results: Mean 25OHD was 102 nmol/L (95% confidence interval (CI) = 98–106 nmol/L). Three percent of residents had a 25OHD concentration of less than 40 nmol/L, 6% <50 nmol/L, and 19% <75 nmol/L. In those who received 20,000 IU/wk or more for 6 months or longer (n = 147), mean 25OHD was 112 nmol/L (95% CI = 108–117 nmol/L), and none had a 25OHD level of less than 50 nmol/L. Hypercalcemia (>2.6 mmol/L), a potential consequence of too much vitamin D, was present in 14%, although 25OHD levels did not differ in those with and without hypercalcemia (108 vs 101 nmol/L; P = .17).

    Conclusion: Twelve months after implementation of a 20,000-IU/wk vitamin D protocol for older adults in residential care, mean 25OHD concentrations were high, and there was no evidence of poor vitamin D status. Given the absence of demonstrated benefit of high 25OHD concentrations to the residential care population, dosages less than 20,000 IU/wk of vitamin D are recommended.