Prevalence of hypovitaminosis D in elderly institutionalized residents: influence of a sustitutive treatment

BACKGROUND: Osteoporosis in the elderly is a common and severe disease, vit amin D deficiency being an important causative factor. Hypovitaminosis D is frequent in old people, particularly those living in nursing homes. SUBJECTS AND METHOD: We performed a cross-sectional study of 100 randomly r ecruited elderly institutionalized subjects. The prevalence of hypovitamino sis D and its possible repercussion on the phosphocalcium metabolism were a ssessed. The degree of sun exposure and the existence of co-morbidity were also recorded. Individuals with hypovitaminosis D were included in a longit udinal study (6 months' duration) aimed at assess the efficacy of treatment with calcium and two different therapeutic regimens with calcidiol (16,000 IU/week or 16,000 IU every 3 weeks). RESULTS: 87% of individuals had hypovitaminosis D; 21.8% of them had second ary hyperparathyroidism. The study population had a low degree of sun expos ure and a high level of comorbidity. The two doses of calcidiol led to a no rmalization of 25-OHD3 levels, increased calciuria and compensated secondar y hyperparathyroidism, yet higher 25-OHD3 levels were achieved with the wee kly therapeutic scheme. CONCLUSIONS: Hypovitaminosis D prevalence appears to be very high In the el derly institutionalized population. Calcium and calcidiol supplementation n ormalized 25-OHD3. improved calcium absorption and compensaed secondary hyp erparathyroidism. Calcium and vitamin D supplementation should be employed routinely in the elderly institutionalized population.