老年学と老年医学の研究

概要

Frail Elderly Hip Fracture Patients and Vitamin D

Pedersen MA, Gregersen M, Langdahl BL and Damsgaard EMS

Background: According to Danish national guidelines, elderly should take vitamin D supplements. The aims of this study were to examine the prevalence of non-supplemented and the prevalence of suboptimal serum vitamin D level among frail elderly hip fracture patients. Furthermore, to determine the gain from serum-25- hydroxyvitamin D (25(OH)D) analysis upon admission and three months later.

Methods: The subjects were frail elderly, defined as 65+ year olds living in nursing homes or sheltered housings, admitted with a hip fracture to the orthopaedic ward. We assessed vitamin D supplementation before and after hip fracture surgery and measured serum-25-(OH)D upon admission and three months later. Serum levels below 75 nmol/l were defined as suboptimal.

Results: A total of 121 patients (59%) did not receive vitamin D supplements, and 73% had suboptimal levels upon admission. We found that the serum-25(OH)D level did not influence the subsequent decision of whether or not to start treatment in the non-supplemented patients. Three months after hip fracture surgery all patients that started treatment, or whose dose was increased, reached optimal vitamin D levels.

Conclusions: A high percentage of frail elderly hip fracture patients did not receive vitamin D supplements. Furthermore a high percentage had a suboptimal level upon admission. Measurement of serum-25(OH)D upon admission seems unnecessary in non-supplemented patients, and may also be so three months later if compliance to vitamin D supplements is closely monitored and no antiresorptive treatment is intended.