Background Elderly dementia patients are prescribed cholecalciferol (vitamin D) when institutionalized in one of our wards. We follow guidelines from the Dutch Health Council, which are evidence-based. No large-scale research, or guidelines are available on vitamin D deficiency and suppletion in institutionalized patient with HD, Korsakov’s syndrome or Acquired Brain Injury. Chel et alfound high prevalence of vitamin D deficiency and insufficiency among 28 patients in a Dutch Skilled Nursing Facility.
Method In 21 institutionalized HD patients we did blood tests to determine the level of vitamin D (serum 25(OH)D level). In these patients, blood samples had to be drawn for other indications, and the vit D level was assessed at the same time.
Aim Assess the prevalence and level of vitamin D deficiency in our institutionalized HD patients.
Results We found deficiency in all patients included. Mean was 25 nmol/l. Range was 3 – 51 nmol/l (rev. 50-150 nmol/l). Some of these patients are on a high kcal diet, adding drinks/meal replacements with added vitamins to their daily intake.
Conclusions Vitamin D deficiency is common in advanced HD.
Recommendations We recommend lab tests on admission, and prescribe monthly vitamin D to all HD patients with deficiency. In severe deficiency a weekly dose is given for three months. Contra indications (sarcoidosis, hyperkalemia, hyperparathyroidism) should be taken into account by prescribers. Exposure to the sun on a daily basis for at least 30 minutes is not always realistic, but advisable.
References Chel VG, Ooms ME, van der Bent J, Veldkamp F, et al. High prevalence of vitamin D deficiency and insufficiency in patients with manifest Huntington disease: An explorative study. Dermatoendocrinol2013;5(3):348-51
- vit D HDpatients