Premium
Exogenous Calciferol (Vitamin D) and Vitamin D Endocrine Status among Elderly Nursing Home Residents in the New York City Area
Author(s) -
O'Dowd Kenneth J.,
Clemens Thomas L.,
Kelsey Jennifer L.,
Lindsay Robert
Publication year - 1993
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1993.tb06950.x
Subject(s) - medicine , vitamin d and neurology , endocrine system , nursing homes , gerontology , vitamin , endocrinology , nursing , hormone
Objective : To determine the role and relative importance of sources of exogenous calciferol (vitamin D) in maintaining vitamin D endocrine status in the mid‐winter and early spring in a representative sample of institutionalized elderly persons in the New York City area. Design : Cross‐sectional survey. Setting : A privately‐run urban nursing home and the long‐term care unit of a suburban public hospital. Participants : Residents aged 60 years and older scheduled for a routine annual physical examination and an additional group of individuals ascertained by random sampling. Those with a history of anti‐convulsant or glucocorticoid use, liver disease, chronic renal disease (or serum creatinine > 1.5 mg/dL), parathyroid disease, Paget's disease, gastric surgery, or pharmacological vitamin D use were excluded. Of 301 sampled individuals, 221 were found eligible to participate, and 109 were successfully enrolled. Results : The average vitamin D intake was 379 IU/day (range 55–1006 IU/day) and total vitamin D intake was below the Recommended Dietary Allowance in 16% of subjects. Fifty percent of total vitamin D intake came from fortified milk, and 26% came from vitamin supplements. Vitamin supplement use was not associated with low dietary intake. Among subjects taking a supplement containing 400 IU/day, none had serum calcidiol levels below 15 ng/mL, while among subjects with vitamin D intake between 200 and 400 IU/day, 46% had serum calcidiol levels below 15 ng/mL and 14% had calcidiol levels below 10 ng/mL. Vitamin D intake from non‐supplement sources (but not from supplements) appeared to have a negative association with serum calcitriol levels. Conclusions : Many nursing home residents may require vitamin supplements in order to achieve optimal levels of calciferol replacement. The choice of a vehicle for calciferol replacement may affect calcitriol levels.