title: Vitamin D supplementation in older adults: searching for specific guidelines in nursing homes.
abstract: BACKGROUND
  The prevalence of vitamin D insufficiency is very high in the nursing home (NH) population. Paradoxically, vitamin D insufficiency is rarely treated despite of strong clinical evidence and recommendations for supplementation. This review aims at reporting the current knowledge of vitamin D supplementation in NH and proposing recommendations adapted to the specificities of this institutional setting.
  
  
  METHODS
  Current literature on vitamin D supplementation for NH residents was narratively presented and discussed by the French Group of Geriatrics and Nutrition.
  
  
  RESULTS
  Vitamin D supplementation is a safe and well-tolerated treatment. Most residents in NH have vitamin D insufficiency, and would benefit from vitamin D supplement. However, only few residents are actually treated. Current specific and personalized protocols for vitamin D supplementation may not be practical for use in NH settings (e.g., assessment of serum vitamin D concentrations before and after supplementation). Therefore, our group proposes a model of intervention based on the systematic supplementation of vitamin D (1,000 IU/day) since the patient's admission to the NH and throughout his/her stay without the need of a preliminary evaluation of the baseline levels. Calcium should be prescribed only in case of poor dietary calcium intake.
  
  
  CONCLUSIONS
  A population-based rather than individual-based approach may probably improve the management of vitamin D insufficiency in the older population living in NH, without increasing the risks of adverse health problems. The clinical relevance and cost effectiveness of this proposal should be assessed under NH real-world conditions to establish its feasibility.
authors.affiliation: Department of Geriatric Medicine, CHU Toulouse, Institute of aging, F-31059 Toulouse, France. rolland.y@chu-toulouse.fr
authors.forename: Y
authors.initials: Y
authors.lastname: Rolland
authors.forename: P
authors.initials: P
authors.lastname: de Souto Barreto
authors.forename: G
authors.initials: G
authors.lastname: Abellan Van Kan
authors.forename: C
authors.initials: C
authors.lastname: Annweiler
authors.forename: O
authors.initials: O
authors.lastname: Beauchet
authors.forename: H
authors.initials: H
authors.lastname: Bischoff-Ferrari
authors.forename: G
authors.initials: G
authors.lastname: Berrut
authors.forename: H
authors.initials: H
authors.lastname: Blain
authors.forename: M
authors.initials: M
authors.lastname: Bonnefoy
authors.forename: M
authors.initials: M
authors.lastname: Cesari
authors.forename: G
authors.initials: G
authors.lastname: Duque
authors.forename: M
authors.initials: M
authors.lastname: Ferry
authors.forename: O
authors.initials: O
authors.lastname: Guerin
authors.forename: O
authors.initials: O
authors.lastname: Hanon
authors.forename: B
authors.initials: B
authors.lastname: Lesourd
authors.forename: J
authors.initials: J
authors.lastname: Morley
authors.forename: A
authors.initials: A
authors.lastname: Raynaud-Simon
authors.forename: G
authors.initials: G
authors.lastname: Ruault
authors.forename: J-C
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: B
authors.initials: B
authors.lastname: Vellas
mesh_terms: D000368:Aged; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000097:blood; D019587:Dietary Supplements; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D009752:Nutritional Status; D017410:Practice Guidelines as Topic; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D
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