There has been a lot of talk about the benefits of Vitamin D for seniors, everything from improving memory loss to reduced mortality, depending on what study you read. In fairness, many physicians start older adults on Vitamin D in the belief that it will decrease falls and fractures. True, seniors are at higher risk of vitamin D deficiency due to factors such as little or no sunlight exposure, malabsorption, frailty, and other comorbidities. Vitamin D supplementation is often ordered because the thought is “it can’t hurt” or that it is “best practice.”
Back to basics, Vitamin D deficiency is extremely common, affecting an estimated 50% of the U.S. population. Vitamin D is not without benefit to be sure, including improved bone health, lessening of infections, and improvements in many disease states such as cancer, diabetes, depression, cognitive decline, and autoimmune disease. However, for long-term care residents, the outcomes of these studies are mixed. For example, in 2019 Canadian Agency for Drugs and Technologies in Health (CADTH) found a statistically significant reduction in falls with Vitamin D supplementation, but the 2021 update revealed that reductions were not always statistically significant.
At the end of the day, the decision to prescribe or deprescribe vitamin D is left up to the individual physician. Given the lack of clear benefit, added pill burden, and cost, it might be something to discuss with your attending physicians. Tomorrow a new study may come out that tells us vitamin D is the miracle drug but for today, the jury is out, we have polypharmacy issues in most of our centers, vitamin D is a fat-soluble vitamin, meaning it is stored in the body, and residents may not be benefiting from taking it. You decide, maybe perform a QAPI audit and determine if physicians are prescribing it as “best practice” versus a true vitamin deficiency! Stay well and stay informed!
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