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
219 items in FALLS and FRACTURES - see also Overview Seniors and Vitamin D
- Overview Fractures and Falls and Vitamin D
- 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
- 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
Hip fracture
- Search Vitamin D Life for "HIP FRACTURE" 191 items not in PDF as of July 2020
- A call to action: Vitamin D for hip fracture – Holick July 2020
- Risk factors for death after hip fracture surgery – 7 of the 8 are associated with low vitamin D – Aug 2020
- 3.5 X higher risk of death 2 years after hip fracture surgery if low vitamin D – Jan 2020
- Hip fracture recovery best with home exercise plus Vitamin D – RCT Dec 2018
- Hip fracture 58 percent more likely if low vitamin D – meta-analysis March 2017
- Fracture risk 40 percent higher risk if low Vitamin D - June 2019
- 1 in 3 died after hip fracture but only 1 in 14 if add Vitamin D and exercise – RCT April 2017
Meta-analyses of Falls/Fractures
- 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
341 items in Seniors see also
Falls and Fractures category listing has
Overview Seniors and Vitamin D
Muscle in Vitamin D Life title,
Overview Fractures and Falls and Vitamin D219 items along with related searches Alzheimers-Cognition - Overview
Cancer - Prostate category listing has
Overview Cancer and vitamin D
Overview Influenza and vitamin D92 items along with related searches Overview Diabetes and vitamin D
Mortality category listing has
Hearing Loss appears to be prevented and treated with vitamin D207 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
Search Vitamin D Life for FRAILITY 691 items as of Aug 2020
Search VitaminDWIKI for "GAIT SPEED" 173 items as of Aug 2020
10 reasons why seniors need more vitamin D has the following- Senior skin produces 3X less Vitamin D for the same sun intensity
- Seniors have fewer vitamin D receptors as they age
(The effect of low Vitamin D receptor genes does not show up on vitamin D test results) - Seniors are indoors more than when when they were younger
not as agile, weaker muscles; frail, no longer enjoy hot temperatures
(if outside, stay in the shade), however, seniors might start outdoor activities like gardening, biking, etc. - Seniors wear more clothing outdoors than when younger
fear skin cancer/wrinkles, sometimes avoid bright light after cataract surgery - Seniors often take various drugs which reduce vitamin D (some would not show up on vitamin D test) statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc
- Seniors often have one or more diseases which consume vitamin D ( osteoporosis, diabetes, MS, ...)
- Seniors generally put on weight at they age - and a heavier body requires more vitamin D
- Seniors often (40%) have fatty livers – which do not process vitamin D as well
- Seniors not have as much Magnesium needed to use vitamin D
(would not show up on vitamin D test) - Seniors with poorly functioning kidneys do not process vitamin D as well
(would not show up on vitamin D test) 2009 full text online Also PDF 2009 - Vitamin D is not as bioavailable in senior digestive systems (Stomach acid or intestines?)
- Category Seniors and Vitamin D
341 items
 Download the PDF from Vitamin D LifeBackground
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.Increasing Vitamin D in aged care facilities to more than 800 IUs did not reduce falls – Oct 2020152 visitors, last modified 07 Oct, 2020, This page is in the following categories (# of items in each category)