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Randomised controlled trial
High-dose monthly vitamin D3 can help to prevent acute respiratory infections in older long-term care residents, but may increase risk of falls
  1. Karin Amrein,
  2. Elisabeth Altendorfer
  1. Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
  1. Correspondence to Dr Karin Amrein, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; karin.amrein{at}medunigraz.at

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Commentary on: 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;65:496-503.

Implications for practice and research 

  • Vitamin D deficiency is rampant in institutionalised elderly individuals. Routine high-dose vitamin D3 appears to prevent acute respiratory infections in this population. This clear benefit must be weighed against a higher risk of falls with monthly vitamin D3 doses.

  • Future research should establish optimised vitamin D supplementation protocols and find the best benefit–risk strategy.

Context

Vitamin D deficiency is common in elderly people, in those with sunlight deprivation, malnutrition and when comorbidities are present. One or all of these factors are often found in nursing home residents, making them one of the most populous risk groups for vitamin D deficiency. The beneficial effect of vitamin D for the prevention of musculoskeletal outcomes is relatively undebated, but the pleiotropic effects of vitamin D suggest further …

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