Vitamin D in the Older Adult: The Vitamin D Conundrum

by Laura A. Stokowski, RN

Vitamin D has received a great deal of attention of late in the scientific and lay literature. Scores of mostly observational studies have investigated the possible role of vitamin D in the prevention of chronic diseases ranging from cancer to cardiovascular disease to autoimmune disorders. No one doubts that vitamin D is essential to the health of older adults; the abundance of vitamin D receptor binding sites throughout the human genome highlight the pleiotropic nature of vitamin D in the human body.^[1] However, this evidence has not consistently translated into proof of clinical benefit, leaving many wondering whether vitamin D supplementation should be recommended for older adults, or if they are fine without it.

The Institute of Medicine (IOM) recently released a new report^[2] that attempts to clear up some of this confusion, at least as far as is possible with current evidence. Dietary Reference Intakes for Calcium and Vitamin D is the product of a comprehensive review of literature and data on the health effects of vitamin D. On the basis of this review, the IOM has revised its 1997 recommendations for dietary intake of vitamin D to maintain the health of North Americans.
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Diet and Lifestyle Still Top Bone Loss Prevention Strategies - in Endocrinology, Osteoporosis from MedPage Today

By Crystal Phend, Senior Staff Writer, MedPage Today

Diet and lifestyle should remain first among osteoporosis management options despite major advances in evidence for and approval of new treatments over the past few years, according to the North American Menopause Society.

The group's position statement on osteoporosis management in the January/February issue of Menopause emphasized that all postmenopausal women should be encouraged to reduce their risk of bone loss and osteoporotic fractures by:

* Maintaining a healthy weight
* Eating a balanced diet
* Obtaining adequate calcium (1,200 mg per day at age 50 and beyond) and vitamin D (800 to 1,000 IU vitamin D3 per day)
* Participating in appropriate exercise
* Avoiding excessive alcohol consumption
* Not smoking
* Taking measures to prevent falls

Periodic reviews of these measures, including annual assessment of fall risk after menopause or whenever physical or mental status changes, were recommended.

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Calcium Scan of Arteries Helps Spot Big Trouble - Forbes.com

(HealthDay News) -- Adding a scan for calcium in the heart arteries to a standard test of blood vessel function helps predict which people with known coronary disease are likely to develop serious problems, a new German study indicates. Read More

Coronary Artery Calcium Screening Predicts Mortality in the Elderly

News Author: Michael O'Riordan The use of coronary artery calcium (CAC) screening is an effective risk-stratification tool in elderly patients, according to the results of a new study. Investigators showed that CAC scoring discriminates mortality risk in these older patients, despite their advanced age and reduced life expectancy, allowing a reclassification of patient risk based on the calcium score. "The use of coronary artery calcium scoring is an effective risk-stratification tool in the elderly as well as young patients, rendering CAC of potential utility even in high-risk patients such as those with diabetes, those with renal failure, smokers, and now the elderly," Dr Paolo Raggi (Emory University School of Medicine, Atlanta, GA) told heartwire. "This study closes the loop around the high-risk patients."