Vitamin D-supplementation in home-dwelling older people and the association with frailty. The ConsuMEER study.
This study measured the use of vitamin D supplements among community-dwelling older adults of 70 years and older, and compared this with the vitamin D supplement use in the Dutch Food Consumption Survey among older adults in 2010-2012 (VCP70+). A secondary aim was to study the association between frailty and adhering to guidelines for vitamin D supplementation.
For this cross-sectional sub study baseline measurements of 94 community-dwelling older adults (70+), who all participated in a randomized controlled trial, were used. The use of vitamin D containing supplements was recorded and categorized as ‘sufficient’ (according to Dutch guidelines, ?20 µg/day), ‘insufficient’ (<20 µg/day) or ‘not at all’. Frailty was evaluated by the ‘Fried frailty criteria’: a participant was categorized as ‘frail’ when 3 of the criteria were scored, and as ‘pre-frail’ when 1 or 2 of the criteria were scored. Differences in supplement use with the VCP70+ were tested with binomial tests; Fisher’s exact test was used to test the association between frailty and vitamin D supplementation.
The percentage of community-dwelling older adults (mean age 80.8 years, 61.7% female) that supplemented vitamin D in accordance with the guidelines (?20 µg/day) was 51,1% (men 44,4%, women 55,2%); this was significantly higher than supplement use among the VCP70+ population (23%, p<0.001). Seven participants were categorized as ‘frail’ and 42 as ‘pre-frail’. There was no difference in supplement use according to guidelines between the three frailty categories (p=0.387).
Discussion and conclusion
Guidelines for vitamin D supplementation for adults of 70 years and older are still insufficiently met, also by more frail community-dwelling older adults. Attention to adequate vitamin D supplementation remains important. For the next VCP it is recommended to also include more vulnerable older adults.