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High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: A Randomized Clinical Trial.
J Am Geriatr Soc. 2017 Mar; 65(3):496-503.JA

Abstract

OBJECTIVES

To determine the efficacy and safety of high-dose vitamin D supplementation for prevention of acute respiratory infection (ARI) in older long-term care residents.

DESIGN

Randomized controlled trial investigating high-dose vs standard-dose vitamin D from 2010 to 2014.

SETTING

Colorado long-term care facilities.

PARTICIPANTS

Long-term care residents aged 60 and older (n = 107).

INTERVENTION

The high-dose group received monthly supplement of vitamin D3 100,000 IU, the standard-dose group received a monthly placebo (for participants taking 400-1,000 IU/d as part of usual care) or a monthly supplement of 12,000 IU of vitamin D3 (for participants taking <400 IU/d as part of usual care).

MEASUREMENTS

The primary outcome was incidence of ARI during the 12-month intervention. Secondary outcomes were falls and fractures, 25-hydroxyvitamin D levels, hypercalcemia, and kidney stones.

RESULTS

Participants (55 high dose, 52 standard dose) were randomized and included in the final analysis. The high-dose group had 0.67 ARIs per person-year and the standard-dose group had 1.11 (incidence rate ratio (IRR) = 0.60, 95% confidence interval (CI) = 0.38-0.94, P = .02). Falls were more common in the high-dose group (1.47 per person-year vs 0.63 in standard-dose group; IRR = 2.33, 95% CI = 1.49-3.63, P < .001). Fractures were uncommon and similar in both groups (high dose 0.10 vs standard dose 0.19 per person-year; P = .31). Mean trough 25-hydroxyvitamin D levels during the trial were 32. ng/mL in the high-dose group and 25.1 ng/mL in the standard-dose group. There was no hypercalcemia or kidney stones in either group.

CONCLUSION

Monthly high-dose vitamin D3 supplementation reduced the incidence of ARI in older long-term care residents but was associated with a higher rate of falls without an increase in fractures.

Authors+Show Affiliations

Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, Colorado.Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado. Geriatric Research, Education and Clinical Center, Eastern Colorado Department of Veterans Affairs, Denver, Colorado.Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, Colorado.Department of Emergency Medicine, School of Medicine, University of Colorado, Aurora, Colorado.Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado. Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado.Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado.Geriatric Research, Education and Clinical Center, Eastern Colorado Department of Veterans Affairs, Denver, Colorado. Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado.

Pub Type(s)

Clinical Trial, Phase II
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27861708

Citation

Ginde, Adit A., et al. "High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: a Randomized Clinical Trial." Journal of the American Geriatrics Society, vol. 65, no. 3, 2017, pp. 496-503.
Ginde AA, Blatchford P, Breese K, et al. High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: A Randomized Clinical Trial. J Am Geriatr Soc. 2017;65(3):496-503.
Ginde, A. A., Blatchford, P., Breese, K., Zarrabi, L., Linnebur, S. A., Wallace, J. I., & Schwartz, R. S. (2017). High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: A Randomized Clinical Trial. Journal of the American Geriatrics Society, 65(3), 496-503. https://doi.org/10.1111/jgs.14679
Ginde AA, et al. High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: a Randomized Clinical Trial. J Am Geriatr Soc. 2017;65(3):496-503. PubMed PMID: 27861708.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long-Term Care Residents: A Randomized Clinical Trial. AU - Ginde,Adit A, AU - Blatchford,Patrick, AU - Breese,Keith, AU - Zarrabi,Lida, AU - Linnebur,Sunny A, AU - Wallace,Jeffrey I, AU - Schwartz,Robert S, Y1 - 2016/11/16/ PY - 2016/11/20/pubmed PY - 2017/7/14/medline PY - 2016/11/19/entrez KW - falls KW - immunosenescence KW - nursing home KW - respiratory infection KW - vitamin D SP - 496 EP - 503 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 65 IS - 3 N2 - OBJECTIVES: To determine the efficacy and safety of high-dose vitamin D supplementation for prevention of acute respiratory infection (ARI) in older long-term care residents. DESIGN: Randomized controlled trial investigating high-dose vs standard-dose vitamin D from 2010 to 2014. SETTING: Colorado long-term care facilities. PARTICIPANTS: Long-term care residents aged 60 and older (n = 107). INTERVENTION: The high-dose group received monthly supplement of vitamin D3 100,000 IU, the standard-dose group received a monthly placebo (for participants taking 400-1,000 IU/d as part of usual care) or a monthly supplement of 12,000 IU of vitamin D3 (for participants taking <400 IU/d as part of usual care). MEASUREMENTS: The primary outcome was incidence of ARI during the 12-month intervention. Secondary outcomes were falls and fractures, 25-hydroxyvitamin D levels, hypercalcemia, and kidney stones. RESULTS: Participants (55 high dose, 52 standard dose) were randomized and included in the final analysis. The high-dose group had 0.67 ARIs per person-year and the standard-dose group had 1.11 (incidence rate ratio (IRR) = 0.60, 95% confidence interval (CI) = 0.38-0.94, P = .02). Falls were more common in the high-dose group (1.47 per person-year vs 0.63 in standard-dose group; IRR = 2.33, 95% CI = 1.49-3.63, P < .001). Fractures were uncommon and similar in both groups (high dose 0.10 vs standard dose 0.19 per person-year; P = .31). Mean trough 25-hydroxyvitamin D levels during the trial were 32. ng/mL in the high-dose group and 25.1 ng/mL in the standard-dose group. There was no hypercalcemia or kidney stones in either group. CONCLUSION: Monthly high-dose vitamin D3 supplementation reduced the incidence of ARI in older long-term care residents but was associated with a higher rate of falls without an increase in fractures. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/27861708/High_Dose_Monthly_Vitamin_D_for_Prevention_of_Acute_Respiratory_Infection_in_Older_Long_Term_Care_Residents:_A_Randomized_Clinical_Trial_ L2 - https://doi.org/10.1111/jgs.14679 DB - PRIME DP - Unbound Medicine ER -