Preliminary results of Vitamin D supplementation in residents of aged care facilities

Introduction: Inadequate vitamin D is associated with osteoporosis and fractures. Vitamin D can be obtained in sufficient amounts from adequate sunlight exposure; however, residents of aged care facilities (ACFs) typically have little sunlight exposure. Subsequently, residents may be at an increased risk of premature death or prolonged rehabilitation due to osteoporotic fractures. It is recommended that all residents be supplemented with 1000 IU vitamin D daily and consume an adequate calcium intake.

Aims: To determine the current rate of vitamin D supplementation amongst residents of ACFs in Tasmania.

Methods: Resident details from consenting Tasmanian ACFs were recorded. Information included demographics, daily vitamin D and calcium supplementation, estimated daily calcium intake, estimated sun exposure, diagnosis of osteoporosis, and history of falls and fractures.

Results: Details of 448 mobile, non-palliative residents (309 female and 139 male) from eight ACFs were obtained. Residents were 849 years of age. Most (n=281, 63%) had little or no sunlight exposure. One hundred and forty-four residents (32%) were recorded as having osteoporosis or a past fracture. Daily vitamin D supplementation of at least 1000 IU occurred in 87 of these residents (60%) and in 162 of 304 residents with neither (53%). There was no statistical difference in supplementation between the groups (P=0.16).

Discussion: Vitamin D supplementation rates remain below desired levels amongst the residents of Tasmanian ACFs, even in the higher risk group of those with a documented history of osteoporosis or fractures. According to the current guidelines for residents of ACFs, all residents should be taking a vitamin D supplement (combined with adequate calcium intake) to improve bone strength and decrease fracture risk. In this population the consequences of fractures include death or a lengthy rehabilitation. Therefore, all positive fracture avoidance measures, such as adequate vitamin D supplementation, should be implemented. Our results strongly suggest the need for an intervention targeted at improving the rates of vitamin D supplementation within ACFs.