High‐Dose Monthly Vitamin D for Prevention of Acute Respiratory Infection in Older Long‐Term Care Residents: A Randomized Clinical Trial
MD, MPH Adit A Ginde, PhD Patrick Blatchford, MA Keith Breese, MPH Lida Zarrabi, PharmD Sunny A Linnebur, MD, MPH Jeffrey I Wallace, MD Robert S Schwartz
Journal of the American Geriatrics Society, doi:10.1111/jgs.14679
Objective-Determine the efficacy and safety of high dose vitamin D supplementation for ARI prevention in older long-term care residents. Design, Setting, and Participants-Randomized controlled trial investigating high dose vs standard dose vitamin D conducted from 2010-2014. Participants were older residents (≥60 years) of Colorado long-term care facilities.
Interventions-1) The high dose group received monthly supplement of 100,000 IU vitamin D 3 ; 2) The standard dose group received either a monthly placebo (for participants taking 400-1,000 IU/day as part of usual care) or a monthly supplement of 12,000 IU of vitamin D 3 (for participants taking <400 IU/day as part of usual care). Main Outcomes-Incidence of ARI during the 12-month intervention. Secondary outcomes included falls/fractures, 25-hydroxyvitamin D levels, hypercalcemia, and kidney stones. Results-We randomized 107 participants (55 high dose, 52 standard dose) and included all in the final analysis. The high dose group had 0.67 ARIs per person-year compared to 1.11 in the standard dose group (incidence rate ratio [IRR] 0.60; 95%CI 0.38-0.94; p= 0.02). Falls were more common in the high dose group (1.47 per person-year) compared to 0.63 in the standard dose group (IRR 2.33; 95%CI 1.49-3.63; p<0.001). Fractures were uncommon and similar in both groups (high dose 0.10 vs standard dose 0.19 per person-year; p=0.31). The mean 25hydroxyvitamin D level during the trial was 32.6 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 D 3 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.
Supplementary Material Refer to Web version on PubMed Central for supplementary material.
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'abstract': '<jats:sec><jats:title>Objectives</jats:title><jats:p>To determine the efficacy and safety of '
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