Vitamin D and Calcium Supplementation at Danish Nursing Homes
- Conditions
- FrailtyAgingMuscle WeaknessPhysical Disability
- Registration Number
- NCT04956705
- Lead Sponsor
- University College Copenhagen
- Brief Summary
Nursing home residents are in high risk of vitamin D deficiency, which negatively affects bone health. Vitamin D and calcium supplements have shown to increase bone density and reduce fracture risk and may affect daily physical functioning. Therefore, The Danish Health Authority recommends all nursing home residents a daily supplement of 20 µg vitamin D and 800-1000 mg calcium. However, adherence to the recommendation is low.
The present project hypothesizes that this low adherence results in a high number of residents with a deficient or insufficient vitamin D status, and that daily physical functioning can be improved or maintained by an improved adherence to the recommendation.
- Detailed Description
Background: Residents in nursing homes belong to one of the high-risk groups when it comes to vitamin D deficiency, which is associated with increased risk of osteoporosis, muscle weakness and generally decreased physical functioning and frailty. Therefore, the Danish Health Authority recommends that all residents in nursing homes receive a daily supplement of 20 µg of vitamin D in addition to 800-1000 mg of calcium. Some systematic reviews and meta-analyses find that daily supplementation of 20 µg of vitamin D can improve physical functioning and muscle strength among older adults, whereas others do not find an effect. However, most studies are performed in non-institutionalized older adults.
An online survey conducted in May 2020 has revealed that the recommendation of giving residents in nursing homes a daily supplement of 20 µg vitamin D and 800-1000 mg calcium is not routine clinical practice in Denmark. The Danish Health Authority highlights The Model for Improvement as a tool to use when working with evidence-based practice within prevention and health promotion in the municipalities.
Objectives:
* To increase use of the recommended supplements with vitamin D and calcium among residents at nursing homes using The Model for Improvement as a methodological tool.
* To investigate the effect of improved vitamin D and calcium supplement use on vitamin D status and daily physical functioning among residents at nursing homes.
Hypotheses:
* Vitamin D status among residents at nursing homes are low and the majority can be defined as vitamin D insufficient.
* Vitamin D status and daily physical functioning of the residents are positively affected by an improved implementation of the recommendation.
Design and Methods: The project has a quasi-experimental design without control groups. It estimates the causal impact of The Model for Improvement on implementing the specific recommendation in a realistic setting at the nursing homes.
The study includes the following endpoints related to the older adults at the nursing homes evaluated before and after the intervention:
* Number of residents at the participating nursing homes taking supplementation of ≥20 µg of vitamin D and/or ≥800 mg of calcium ≥5 days/week.
* Number of residents at the participating nursing homes classified as having an insufficient and deficient vitamin D status (serum 25-hydroxyvitamin D (25(OH)D \<50 nmol/L and \<25 nmol/L, respectively)
* Mean daily physical functioning measured as muscle strength, 30-s chair-stand test, and a timed-up-and-go test.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 109
- Being a resident at the participating nursing homes
- Understand and speak Danish in order to understand the study procedures
- Be able to give informed consent
- Having kidney diseases
- Receiving medication which may induce adverse effects in combination with vitamin D and/or calcium supplements
- Being terminally ill
- Declared incompetent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Primary Outcome Measures
Name Time Method Number of residents having vitamin D and calcium supplements daily 6 months Assessed as those having ≥ 20 µg vitamin D and/or ≥ 800 mg calcium ≥ 5 days /week
- Secondary Outcome Measures
Name Time Method Vitamin D status 6 months Assessed as 25-hydroxyvitamin D
Physical functioning 6 months Assessed with timed-up-and-go test and 30-s chair-stand test
Handgrip strength 6 months Assessed with a digital handgrip dynamometer
Trial Locations
- Locations (2)
Frederiksgadecenteret
🇩🇰Haslev, Denmark
Plejecentret Solbakken
🇩🇰Ringsted, Denmark
Frederiksgadecenteret🇩🇰Haslev, Denmark