title: High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: A Randomized Clinical Trial.
abstract: OBJECTIVE
  To determine the efficacy and safety of high-dose vitamin D supplementation for prevention of acute respiratory infection (ARI) in older long-term care residents.
  
  
  METHODS
  Randomized controlled trial investigating high-dose vs standard-dose vitamin D from 2010 to 2014.
  
  
  METHODS
  Colorado long-term care facilities.
  
  
  METHODS
  Long-term care residents aged 60 and older (n = 107).
  
  
  METHODS
  The high-dose group received monthly supplement of vitamin D3100,000 IU, the standard-dose group received a monthly placebo (for participants taking 400-1,000 IU/d as part of usual care) or a monthly supplement of 12,000 IU of vitamin D3(for participants taking <400 IU/d as part of usual care).
  
  
  METHODS
  The primary outcome was incidence of ARI during the 12-month intervention. Secondary outcomes were falls and fractures, 25-hydroxyvitamin D levels, hypercalcemia, and kidney stones.
  
  
  RESULTS
  Participants (55 high dose, 52 standard dose) were randomized and included in the final analysis. The high-dose group had 0.67 ARIs per person-year and the standard-dose group had 1.11 (incidence rate ratio (IRR) = 0.60, 95% confidence interval (CI) = 0.38-0.94, P = .02). Falls were more common in the high-dose group (1.47 per person-year vs 0.63 in standard-dose group; IRR = 2.33, 95% CI = 1.49-3.63, P < .001). Fractures were uncommon and similar in both groups (high dose 0.10 vs standard dose 0.19 per person-year; P = .31). Mean trough 25-hydroxyvitamin D levels during the trial were 32. ng/mL in the high-dose group and 25.1 ng/mL in the standard-dose group. There was no hypercalcemia or kidney stones in either group.
  
  
  CONCLUSIONS
  Monthly high-dose vitamin D3supplementation reduced the incidence of ARI in older long-term care residents but was associated with a higher rate of falls without an increase in fractures.
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
authors.forename: Adit A
authors.initials: AA
authors.lastname: Ginde
authors.affiliation: Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado.|Geriatric Research, Education and Clinical Center, Eastern Colorado Department of Veterans Affairs, Denver, Colorado.
authors.forename: Patrick
authors.initials: P
authors.lastname: Blatchford
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
authors.forename: Keith
authors.initials: K
authors.lastname: Breese
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
authors.forename: Lida
authors.initials: L
authors.lastname: Zarrabi
authors.affiliation: Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado.|Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
authors.forename: Sunny A
authors.initials: SA
authors.lastname: Linnebur
authors.affiliation: Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Wallace
authors.affiliation: Geriatric Research, Education and Clinical Center, Eastern Colorado Department of Veterans Affairs, Denver, Colorado.|Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Schwartz
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D002762:Cholecalciferol / Q000008:administration & dosage*; D003120:Colorado / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D008297:Male; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000517:prevention & control*; D012866:Skilled Nursing Facilities; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D
keywords: falls; immunosenescence; nursing home; respiratory infection; vitamin D