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Increasing Vitamin D in aged care facilities to more than 800 IUs did not reduce falls – Oct 2020

Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study

BMC Geriatrics volume 20, Article number: 383 (2020)
Pippy Walker, Annette Kifley, Susan Kurrle & Ian D. Cameron


Problems with the approach include:

  1. >800 IU is barely enough to have more benefit than than a placebo
  2. Need than just Vitamin D to reduce falls - such as exercise, protein, Magnesium, Vitamin K
  3. A gut-friendly form of vitamin D should be used for all seniors as many have digestive problems

Falls and Fractures category contains the following



Meta-analyses of Falls/Fractures

Seniors start with

431 items in Seniors

see also
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Nursing homes and Vitamin D - many studies
13 reasons why many seniors need more vitamin D (both dose and level) - July 2023 has:

  1. Senior skin produces 4X less Vitamin D for the same sun intensity
  2. Seniors have fewer vitamin D receptor genes as they age
    Receptors are needed to get Vitamin D in blood actually into the cells
  3. Many other Vitamin D genes decrease with age
  4. Since many gene activations are not detected by a blood test,
    more Vitamin D is often needed, especially by seniors
  5. Seniors are indoors more than when they were younger
    not as agile, weaker muscles; frail, no longer enjoy hot temperatures
  6. Seniors wear more clothing outdoors than when younger
    Seniors also are told to fear skin cancer & wrinkles
  7. Seniors often take various drugs which end up reducing vitamin D
    Some reductions are not detected by a vitamin D test of the blood
    statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc
  8. Seniors often have one or more diseases that consume vitamin D
    osteoporosis, diabetes, Multiple Sclerosis, Cancer, ...
  9. Seniors generally put on weight as they age - and a heavier body requires more vitamin D
  10. Seniors often (40%) have fatty livers – which do not process vitamin D as well
  11. Reduced stomach acid means less Magnesium is available to get vitamin D into the cells
  12. Vitamin D is not as bioavailable in senior intestines
  13. Seniors with poorly functioning kidneys do not process vitamin D as well
       Seniors category has 431 items

 Download the PDF from VitaminDWiki

Adequate (≥800 IU/day) vitamin D supplement use in Australian residential aged care facilities (RACFs) is variable and non-optimal. The vitamin D implementation (ViDAus) study aimed to employ a range of strategies to support the uptake of this best practice in participating facilities. The aim of this paper is to report on facility level prevalence outcomes and factors associated with vitamin D supplement use.

This trial followed a stepped wedge cluster, non-randomised design with 41 individual facilities serving as clusters pragmatically allocated into two wedges that commenced the intervention six months apart. This multifaceted, interdisciplinary knowledge translation intervention was led by a project officer, who worked with nominated champions at participating facilities to provide education and undertake quality improvement (QI) planning. Local barriers and responsive strategies were identified to engage stakeholders and promote widespread uptake of vitamin D supplement use.

This study found no significant difference in the change of vitamin D supplement use between the intervention (17 facilities with approx. 1500 residents) and control group (24 facilities with approx. 1900 residents) at six months (difference in prevalence change between groups was 1.10, 95% CI − 3.8 to 6.0, p = 0.6). The average overall facility change in adequate (≥800 IU/day) vitamin D supplement use over 12 months was 3.86% (95% CI 0.6 to 7.2, p = 0.02), which achieved a facility level average prevalence of 59.6%. The variation in uptake at 12 months ranged from 25 to 88% of residents at each facility. In terms of the types of strategies employed for implementation, there were no statistical differences between facilities that achieved a clinically meaningful improvement (≥10%) or a desired prevalence of vitamin D supplement use (80% of residents) compared to those that did not.

This work confirms the complex nature of implementation of best practice in the RACF setting and indicates that more needs to be done to ensure best practice is translated into action. Whilst some strategies appeared to be associated with better outcomes, the statistical insignificance of these findings and the overall limited impact of the intervention suggests that the role of broader organisational and governmental support for implementation should be investigated further.

Created by admin. Last Modification: Wednesday October 7, 2020 09:09:36 GMT-0000 by admin. (Version 4)

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