Vitamin D deficiency in nursing home residents: a systematic review

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Abstract

CONTEXT: Vitamin D deficiency is a global public health issue, particularly in nursing home residents.

OBJECTIVE: This review critically summarizes the prevalence of vitamin D deficiency in nursing home residents worldwide. In addition, it outlines the effect of vitamin D intervention, alone or in combination with other nutrients or therapies, on improving vitamin D status and associated health outcomes in nursing home residents.

DATA SOURCES, EXTRACTION, AND ANALYSIS: Searches were conducted of electronic databases for articles published from 2010 to May 2021. After screening of the 366 papers initially identified, 58 articles were included.

CONCLUSIONS: A paucity of observational studies in nursing homes suggests a high prevalence of vitamin D deficiency ranging from 8% [25(OH)D <25 nmol/L], up to 94% [25(OH)D <50 nmol/L] in some cohorts where supplement use was low. Reported factors associated with deficiency and suboptimal vitamin D status include lack of sunlight exposure, poor dietary intake of vitamin D, limited vitamin D food fortification, frailty, poor renal function, and low use of vitamin D supplements. Residents who are severely deficient, deficient, or insufficient in vitamin D require remedial vitamin D supplementation prior to maintenance supplementation at doses >800 IU/day. High-dose vitamin D supplementation may reduce respiratory illness; however, supportive data are limited. Oral nutritional supplements, in combination with exercise, may benefit physical function and performance, whereas supplementation with vitamin D- and calcium-fortified foods has been associated with improved quality of life and reduced bone resorption. Globally, vitamin D deficiency is highly prevalent in nursing home residents. There is an urgent need for standardized dietary and supplementation guidelines to prevent deficiency in this vulnerable group.

Original languageEnglish
Article numbernuac091
Pages (from-to)1-19
Number of pages19
JournalNutrition Reviews
Volume81
Issue number7
Early online date11 Nov 2022
DOIs
Publication statusPublished online - 11 Nov 2022

Bibliographical note

© The Author(s) 2022. Published by Oxford University Press on behalf of the International Life Sciences Institute.

Keywords

  • status
  • 25(OH)D
  • supplementation
  • older adults
  • Aged
  • aged ≥80 years
  • musculoskeletal health
  • nursing home
  • vitamin D

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