Multivitamin supplementation improves nutritional status and bone quality in aged care residents

Grieger, Jessica A.; Nowson, Caryl; Jarman, Heather F.; Malon, R. G.; Ackland, M. Leigh

doi:10.1038/sj.ejcn.1602963

Cited by 34 publications

(39 citation statements)

References 27 publications

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“…A 4% incidence of B12 deficiency indicates that B12 status is a relevant form of malnutrition in this population. Yet, the present study provides evidence that B12 status is amenable to treatment, which is consistent with extant literature on intervention studies (Baker et al 1980;Wouters-Wesseling et al 2002;Grieger et al 2009;Rozgony et al 2010;Favrat et al 2011). Whether this remains true for older adults after admission to LTC remains unknown and further evidence for burden of illness and establishing causality of improved B12 status on clinical outcomes is warranted.…”

Section: Discussionsupporting

confidence: 76%

Vitamin B₁₂ status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor

Pfisterer

Sharratt

Heckman

et al. 2016

Appl. Physiol. Nutr. Metab.

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Vitamin B 12 (B12) deficiency, although treatable, impacts up to 43% of community-living older adults; long-term care (LTC) residents may be at greater risk. Recommendations for screening require further evidence on prevalence and incidence in LTC. Small, ungeneralizable samples provide a limited perspective on these issues. The purposes of this study were to report prevalence of B12 deficiency at admission to LTC, incidence 1 year post-admission, and identify subgroups with differential risk. This multi-site (8), retrospective prevalence study used random proportionate sampling of resident charts (n = 412). Data at admission extracted included demographics, B12 status, B12 supplementation, medications, diagnoses, functional independence, cognitive performance, and nutrition. Prevalence at admission of B12 deficiency (<156 pmol/L) was 13.8%; 47.6% had normal B12 (>300 pmol/L). One year post-admission incidence was 4%. Better B12 status was significantly associated with supplementation use prior to LTC admission. Other characteristics were not associated with status. This work provides a better estimate of B12 deficiency prevalence than previously available for LTC, upon which to base protocols and policy. Prospective studies are needed to establish treatment efficacy and effect on health related outcomes.Key words: vitamin B12 deficiency prevalence, older adults, long-term care, micronutrient malnutrition, incidence.Résumé : La déficience en vitamine B 12 (B12) bien que traitable, touche jusqu'à 43 % des personnes âgées vivant dans une communauté; les patients aux soins de longue durée (SLD) seraient plus à risque. Il faut plus de données probantes sur la prévalence et l'incidence dans les SLD pour proposer des recommandations en matière de dépistage. Des études menées auprès d'échantillons restreints ne permettant pas de généralisation présentent une perspective limitée à ce sujet. Cette étude a pour objectif de rapporter la prévalence de déficience en vitamine B12 au moment de l'admission aux SLD, l'incidence un an plus tard et d'identifier des sous-groupes présentant un risque différent. Cette étude rétrospective sur la prévalence réalisée à plusieurs sites (8) utilise un échantillonnage aléatoire proportionnel des dossiers de résidents (n = 412). Les données utilisées à l'admission sont : démographiques, statut en vitamine B12, supplémentation en vitamine B12, médication, diagnostic, autonomie fonctionnelle, performance cognitive et nutrition. La prévalence de déficience en B12 (<156 pmol/L) à l'admission est de 13,8 %; 47,6 % présentent un taux normal de B12 (>300 pmol/L). Un an après l'admission, l'incidence est de 4 %. Un meilleur statut en B12 est significativement associé à la consommation de suppléments avant l'admission aux SLD. Les autres variables ne sont pas associées au statut en B12. Cette étude procure une meilleure estimation de la prévalence de la déficience en B12 comparativement à ce qui était antérieurement disponible pour les SLD; cette étude permet d'établir des protocoles et un...

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Section: Discussionsupporting

confidence: 76%

Vitamin B₁₂ status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor

Pfisterer

Sharratt

Heckman

et al. 2016

Appl. Physiol. Nutr. Metab.

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“…Nevertheless, our finding is consistent with previous studies that have yielded positive or at least encouraging data supporting the use of biologically based therapies (e.g., vitamins and minerals) and better functional status. 20,21 This analysis also found that the use of manipulative and body-based therapies predicts better functional status, better physical HRQoL, and better mental-health related quality of life. Manipulative and body-based therapies include chiropractic and massage therapy.…”

Section: Discussionmentioning

confidence: 77%

Effects of Complementary Therapy on Health in a National U.S. Sample of Older Adults

Nguyen

Grzywacz

Lang

et al. 2010

The Journal of Alternative and Complementary Medicine

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Objectives: The study objectives were to identify types of complementary therapy that are most predictive of health outcomes, including functional status, physical health-related quality of life (HRQoL), and mental HRQoL among older adults. Design: This was a prospective study. Settings/location: The study comprised computer-assisted interviews conducted in participants' homes. Results: The use of biologically based therapies predicted better functional status, such that users reported less functional impairment than nonusers ( p < 0.01), adjusting for age, gender, race/ethnicity, education, health insurance, household income, and comorbid conditions. Users of manipulative and body-based methods reported less functional impairment ( p < 0.05). They also reported better physical and mental health-related quality of life, though these relationships were marginally significant. Other groups of therapies, alternative medical systems, mind-body therapies, and prayer were not predictive of either functional status or HRQoL. Conclusions: Favorable effects were observed among users of biologically based therapies and users of manipulative and body-based methods. Other types of complementary therapy had no effects on health status over a 1-year follow-up period.

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“…Nine trials (584 participants) provided 12 comparisons of two different exercise programmes (Faber 2006; Fu 2015; Imaoka 2016; Kovacs 2012; Saravanakumar 2014; Shimada 2004; Serra-Rexach 2011; Sitja Rabert 2015; Tuunainen 2013). All trials were individually randomised.…”

Section: Resultsmentioning

confidence: 99%

Interventions for preventing falls in older people in care facilities and hospitals

Cameron

Dyer²,

Panagoda

et al. 2018

Cochrane Database of Systematic Reviews

355

370

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Background Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012. Objectives To assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. Selection criteria Randomised controlled trials of interventions for preventing falls in older people in residential or nursing care facilities, or hospitals. Data collection and analysis One review author screened abstracts; two review authors screened full‐text articles for inclusion. Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction. We calculated rate ratios (RaR) with 95% confidence intervals (CIs) for rate of falls and risk ratios (RRs) and 95% CIs for outcomes such as risk of falling (number of people falling). We pooled results where appropriate. We used GRADE to assess the quality of evidence. Main results Thirty‐five new trials (77,869 participants) were included in this update. Overall, we included 95 trials (138,164 participants), 71 (40,374 participants; mean age 84 years; 75% women) in care facilities and 24 (97,790 participants; mean age 78 years; 52% women) in hospitals. The majority of trials were at high risk of bias in one or more domains, mostly relating to lack of blinding. With few exceptions, the quality of evidence for individual interventions in either setting was generally rated as low or very low. Risk of fracture and adverse events were generally poorly reported and, where reported, the evidence was very low‐quality, which means that we are uncertain of the estimates. Only the falls outcomes for the main comparisons are reported here. Care facilities Seventeen trials compared exercise with control (typically usual care alone). We are uncertain of the effect of exercise on rate of falls (RaR 0.93, 95% CI 0.72 to 1.20; 2002 participants, 10 studies; I² = 76%; very low‐quality evidence). Exercise may make little or no difference to the risk of falling (RR 1.02, 95% CI 0.88 to 1.18; 2090 participants, 10 studies; I² = 23%; low‐quality evidence). There is low‐quality evidence that general medication review (tested in 12 trials) may make little or no difference to the rate of falls (RaR 0.93, 95% CI 0.64 to 1.35; 2409 participants, 6 studies; I² = 93%) or the risk of falling (RR 0.93, 95% CI 0.80 to 1.09; 5139 participants, 6 studies; I² = 48%). There is moderate‐quality evidence that vitamin D supplementation (4512 particip...

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Multivitamin supplementation improves nutritional status and bone quality in aged care residents

Cited by 34 publications

References 27 publications

Vitamin B₁₂ status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor

Vitamin B₁₂ status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor

Effects of Complementary Therapy on Health in a National U.S. Sample of Older Adults

Interventions for preventing falls in older people in care facilities and hospitals

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Multivitamin supplementation improves nutritional status and bone quality in aged care residents

Cited by 34 publications

References 27 publications

Vitamin B12 status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor

Vitamin B12 status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor

Effects of Complementary Therapy on Health in a National U.S. Sample of Older Adults

Interventions for preventing falls in older people in care facilities and hospitals

Contact Info

Product

Resources

About

Vitamin B₁₂ status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor

Vitamin B₁₂ status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor