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:
- >800 IU is barely enough to have more benefit than than a placebo
- Need than just Vitamin D to reduce falls - such as exercise, protein, Magnesium, Vitamin K
- 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
258 items in FALLS and FRACTURES - Vitamin D and Calcium cost-effectively reduce falls and fractures – April 2019
- see also Overview Seniors and Vitamin D
Falls
- Fall prevention - Vitamin D is one of the ways - umbrella review Jan 2024
- Deaths due to falls doubled in just a decade (age-adjusted, perhaps decreased vitamin D) – June 2019
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Falls cut in half by 100,000 IU vitamin D monthly - RCT 2016
- Falls reduced by a third if achieved 40 ng level vitamin D– RCT Sept 2018
- Note: It took 6 months to get to that level. Most trials last only 3 months
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Falls reduced by Vitamin D: 13 percent reduction if more than 700 IU – review of 38 trials – Aug 2022
Fracture
- Hip fractures are predicted by 10 factors – low Vitamin D is the biggest – Aug 2023
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Low trauma bone fractures in seniors – considering Vitamin D loading dose for all, without testing – Nov 2019
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- 75+ Hip fracture items in VitaminDWiki title Click here for details
Meta-analyses of Falls/Fractures
- No increase in falls, fractures or all-cause mortality when Vitamin D is given monthly or less often– meta-analysis April 2024
- 100,000 IU of Vitamin D monthly (27 ng) is not enough to reduce fractures and falls – meta-analysis April 2024
- Increased risk of fracture if high level of Vitamin D (if continue to take Calcium) – umbrella analysis of meta-analyses Nov 2020
- Hip fractures not prevented by Vitamin D (800 IU daily or large quarterly or annual doses) – meta-analysis – Dec 2019
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- Vitamin D not help fractures and falls if not vitamin D deficient – meta-analysis Oct 2018
- Fractures not reduced by small amounts of vitamin D - meta-analysis Dec 2017
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Hip fracture 58 percent more likely if low vitamin D – meta-analysis March 2017
- Fracture risk reduced somewhat by 800 IU of vitamin D and Calcium – meta-analysis Oct 2015
- Acute fracture patients – 70 percent were vitamin D deficient – meta-analysis Sept 2015
- Falls not prevented by vitamin D given every 3 months or less often – meta-analysis Jan 2015
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Bone fractures reduced by a minimum of 800 IU vitamin D and Calcium – meta-meta-analysis March 2014
- Fractures reduced with any amount of vitamin D and some Calcium - Cochraine April 2014
- Fallers often had less than 20 ng of vitamin D – meta-analysis April 2014
- Hip fractures greatly reduced by sunshine, vitamin D, and vitamin K – meta-analysis Sept 2012
- Vitamin D may prevent falls and fractures without Calcium – an overview of 9 meta-analysis – Oct 2012
- Hip fractures reduced 30 percent with 800 IU of vitamin D – meta-analysis July 2012
- Vitamin D reduces falls – meta-analysis Oct 2011
- Active form of vitamin D (calcitriol) cut in half the fractures following organ transplant – meta-analysis Aug 2011
- 1000 IU minimum to decrease falls and fractures Swiss - 2009
- Meta-analysis of falls and 800+ IU of vitamin D found good results – June 2010
- 800 IU vitamin D reduces falls - Dec 2009
Seniors start with
431 items in Seniors see also
Falls and Fractures category listing has
Overview Seniors and Vitamin D
Muscles and Vitamin D - many studies 125+ items
Overview Fractures and Falls and Vitamin D258 items along with related searches Overview Alzheimer's-Cognition and Vitamin D
Cancer - Prostate category listing has
Overview Cancer and vitamin D
Overview Influenza and vitamin D103 items along with related searches Overview Diabetes and vitamin D
Mortality category listing has
Hearing Loss appears to be prevented and treated with vitamin D320 items along with related searches Overview Osteoporosis and vitamin D
Restless Legs Syndrome dramatically reduced by vitamin D, etc
Overview Rheumatoid Arthritis and vitamin D
Frailty and Vitamin D - many studies many studies
Nursing homes and Vitamin D - many studies
13 reasons why many seniors need more vitamin D (both dose and level) - July 2023 has:- Senior skin produces 4X less Vitamin D for the same sun intensity
- Seniors have fewer vitamin D receptor genes as they age
Receptors are needed to get Vitamin D in blood actually into the cells - Many other Vitamin D genes decrease with age
- Since many gene activations are not detected by a blood test,
more Vitamin D is often needed, especially by seniors - Seniors are indoors more than when they were younger
not as agile, weaker muscles; frail, no longer enjoy hot temperatures - Seniors wear more clothing outdoors than when younger
Seniors also are told to fear skin cancer & wrinkles - 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 - Seniors often have one or more diseases that consume vitamin D
osteoporosis, diabetes, Multiple Sclerosis, Cancer, ... - Seniors generally put on weight as they age - and a heavier body requires more vitamin D
- Seniors often (40%) have fatty livers – which do not process vitamin D as well
- Reduced stomach acid means less Magnesium is available to get vitamin D into the cells
- Vitamin D is not as bioavailable in senior intestines
- Seniors with poorly functioning kidneys do not process vitamin D as well
- Glutathione (which increases Vitamin D getting to cells) decreases with age
Seniors category has431 items
Download the PDF from VitaminDWikiBackground
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.Methods
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.Results
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.Conclusions
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.Printer Friendly Follow this page for updates6378 visitors, last modified 07 Oct, 2020,